Blomgren, David A
Blomgren, David A is an individual health care provider with primary practice located at 14402 E Sprague Ave , Spokane Valley WA 99216-2167. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Blomgren, David A can be contacted via phone (509) 922-2625.Contact Information
Primary practice address
14402 E Sprague Ave
Spokane Valley WA 99216-2167
Phone: (509) 922-2625
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA10000150 | Washington |
Profile Details
| NPI number | 1184788127 |
|---|---|
| LBN Legal business name | Blomgren, David A |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 21st, 2006 |
| Last updated | May 9th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184788127 | NPPES |
| Washington | MEDICAID | 8487605 |
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