Individual
MR. KYLE BLANCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
P3839 RAILROAD AVE, JBLM, WA 98433
(253) 967-0877
(253) 967-0879
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
363A00000X
Physician Assistant
Primary
61626132
WA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
04/20/2023
Last updated
12/12/2024
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