Blickenstaff, Robert Cory

Blickenstaff, Robert Cory is an individual health care provider with primary practice located at 717 Ne 61St St Suite 203, Vancouver WA 98665-8753. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Blickenstaff, Robert Cory can be contacted via phone (360) 600-2272.

Contact Information

Primary practice address
717 Ne 61St St Suite 203 Vancouver WA 98665-8753
Phone: (360) 600-2272
Fax: (877) 362-9612
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT00009330 Washington

Profile Details

NPI number 1760478762
LBN Legal business name Blickenstaff, Robert Cory
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2005
Last updated Apr 6th, 2011 - about 14 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 1760478762 NPPES
Washington Other 179487 LABOR & IND.
Washington MEDICAID 232559 LABOR & IND.
Washington MEDICAID 8382467 LABOR & IND.

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