# MELANY K. BLOOMQUIST, DDS, PS

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

## Provider details

- **NPI number:** 1770999534
- **Authorized official:** DR. MELANY KAY BLOOMQUIST DDS, PS (PRESIDENT)
- **Authorized official phone:** (360) 871-5100

## Contact information

- **Practice address:** 1590 WOODRIDGE DR SE, PORT ORCHARD, WA 98366-3818
- **Practice address phone:** (360) 871-5100
- **Practice address fax:** (360) 871-5104
- **Mailing address:** 1590 WOODRIDGE DR SE, PORT ORCHARD, WA 98366-3818
- **Mailing address phone:** (360) 871-5100
- **Mailing address fax:** (360) 871-5104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 7314 | WA | Yes |

## Other

- **Enumeration date:** 07/01/2014
- **Last updated:** 07/01/2014