Corinne Elizabeth Gaddis, ATC, ATC/L

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A160251276 Issued in WA

Practice address

825 SE Bishop Blvd
Suite 120
Pullman, WA 99163-5517

Phone

(509) 332-2828

Fax

(509) 334-7474

NPI assigned

Jul 2, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1447690672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 NW NORTH ST",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991633632",
            "telephone_number": "360-672-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD",
            "address_2": "SUITE 120",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "509-332-2828",
            "fax_number": "509-334-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDIS",
        "first_name": "CORINNE",
        "middle_name": "ELIZABETH",
        "credential": "ATC, ATC/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160251276",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ID",
            "license": "AT-459",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Owen Free
• Dennis P Fritz, AGENCY AFFILIATED RE
• Michael J Frostad, MD
• Ann Akiko Fujimoto-Distefano, DPT
• Sloan Clare Fuller, LCPC
• Nicholas Gallotto
• Clara E Garcia, MD
• Eddie Raul Garcia, ATC
• Hanna E. Gash, SW AAL
• Keith M Gautreaux, M.D.

• Athletic Trainer in Pullman, WA
• Providers in Pullman, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.