Blacklock, Diana Lee

Blacklock, Diana Lee is an individual health care provider with primary practice located at 2426 20Th St Se , Puyallup WA 98374-1475. She recently has only one registered license in Other Service Providers / Health Educator, which is considered as her primary health care specialty. Blacklock, Diana Lee can be contacted via phone (253) 229-4272.

Contact Information

Primary practice address
2426 20Th St Se Puyallup WA 98374-1475
Phone: (253) 229-4272
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Health Educator 174H00000X

Profile Details

NPI number 1912225822
LBN Legal business name Blacklock, Diana Lee
Credentials LMP
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2010
Last updated May 17th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912225822 NPPES
Washington Other 60141204 LICENSED MASSAGE THERAPISTS

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