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Individual

ELIZABETH BLODNICK HERRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
105 W 8TH AVE, SUITE 7050, SPOKANE, WA 99204-2302
(509) 252-1711
Mailing address
1930 W BROADWAY ST, STE A, MISSOULA, MT 59808-1820
(406) 541-6844
(417) 719-7896

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3719
CO
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-49941
MT
363A00000X
Physician Assistant
PA60610762
WA

Other

Enumeration date
06/27/2013
Last updated
08/04/2021
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