Individual
JULIETA MONTINA BLAGRAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2095 CROSSWOODS CIR, OAK HARBOR, WA 98277-8860
(360) 675-5058
Mailing address
2095 CROSSWOODS CIR, OAK HARBOR, WA 98277-8860
(360) 675-5058
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3747A0650X-TECHNICIA
—
WA
Enumeration date
12/03/2020
Last updated
12/03/2020
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