# BLAKE HERBISON DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013191006
- **Authorized official:** DR. BLAKE HERBISON D.D.S. (MEMBER)
- **Authorized official phone:** (425) 486-2727

## Contact information

- **Practice address:** 18520 101ST AVE NE, BOTHELL, WA 98011-3804
- **Practice address phone:** (425) 486-2727
- **Mailing address:** 22826 36TH AVE SE, BOTHELL, WA 98021-6203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE00011059 | WA | Yes |

## Other

- **Enumeration date:** 12/26/2007
- **Last updated:** 08/08/2013