Individual provider · Type 1 NPI

Corey Mark Pendergraft, MD

Student in an Organized Health Care Education/Training Program · Pullman, WA

NPI number 1528857372 Active

Practice location

Wsu Family Medicine Residency Center, 825 SE Bishop Blvd Ste 401
Pullman, WA 99163

Call (509) 336-7720 Map

Mailing address

825 SE Bishop Blvd Ste 401
Pullman, WA 99163-5517

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000XML61690777 (WA)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1528857372

Corey Mark Pendergraft, MD's National Provider Identifier is 1528857372, issued on May 6, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Pullman, WA. The record was last updated on Feb 2, 2026.