# BLAKE DAVIS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kirkland and Redmond Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780367771
- **Authorized official:** TAMI HANIGAN (OPERATIONS DIRECTOR)
- **Authorized official phone:** (425) 821-0808

## Contact information

- **Practice address:** 12819 120TH AVE NE STE H, KIRKLAND, WA 98034-3002
- **Practice address phone:** (425) 821-0808
- **Mailing address:** 12819 120TH AVE NE STE H, KIRKLAND, WA 98034-3002
- **Mailing address phone:** (425) 821-0808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/08/2023
- **Last updated:** 08/08/2023