Individual
NICHOLLE LYNN BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
401 BUSTER RD, TOPPENISH, WA 98948-9792
(509) 865-2102
Mailing address
PO BOX 151, TOPPENISH, WA 98948-0151
(509) 865-2102
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH60594779
WA
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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