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1861405227
TODD DAVID BLAKLEY
VANCOUVER, WA
NPI
1861405227
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: WA WA PA10003448)
Enumeration Date
2006-08-15
Last Update Date
2007-07-08
Business Address
-- TODD DAVID BLAKLEY Physician Assistant
14406 NE 20TH AVE
VANCOUVER, WA 98686-1448
Phone number: 360-571-3053
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Mailing Address
-- TODD DAVID BLAKLEY Physician Assistant
3905 NW 119TH ST
VANCOUVER, WA 98685-3593
Phone number: 360-571-3053
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