| NPI | 1215125646 |
|---|---|
| Former Name | KRISTEN GAYLE BLANKEMEIER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60247903) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA 19336) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2016-07-22 |