Blalock, Amanda Jane

Blalock, Amanda Jane is an individual health care provider with primary practice located at 1230 Monitor St , Wenatchee WA 98801-3534. She recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Blalock, Amanda Jane can be contacted via phone (509) 232-5766.

Contact Information

Primary practice address
1230 Monitor St Wenatchee WA 98801-3534
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Addiction (Substance Use Disorder) 163WA0400X RN60984309 Washington

Profile Details

NPI number 1679121651
LBN Legal business name Blalock, Amanda Jane
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2019
Last updated Sep 3rd, 2019 - about 5 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 1679121651 NPPES
Washington MEDICAID 2077844

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