Individual
BLAYNE ANTHONY CLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
325 E PIONEER, PUYALLUP, WA 98372-3265
(253) 697-8400
(253) 697-3730
Mailing address
325 E PIONEER, PUYALLUP, WA 98372-3265
(253) 697-8400
(253) 697-3730
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61035681
WA
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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