Individual
BLAZE CREATURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2103 S ATLANTIC ST APT 309, SEATTLE, WA 98144-3615
(206) 329-2050
Mailing address
215 S ORCAS ST, SEATTLE, WA 98108-2442
(206) 317-7555
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
07/02/2023
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