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Individual

RYAN V BLANCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
600 BROADWAY, SUITE 190, SEATTLE, WA 98122-5395
(206) 323-4040
(206) 324-0943
Mailing address
600 BROADWAY, SUITE 190, SEATTLE, WA 98122-5395
(206) 323-4040
(206) 324-0943

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OI00000319
WA
224P00000X
Prosthetist
Primary
PS00000319
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9036963
WA
Enumeration date
08/09/2007
Last updated
08/09/2007
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