Individual
ZACHARIAH FRANCIS BLAYLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SUDPT
Contact information
Practice address
3430 E HIGHWAY 101 STE 3, PORT ANGELES, WA 98362-9069
(360) 452-4062
(360) 452-4189
Mailing address
PO BOX 478, PORT ANGELES, WA 98362-0072
(360) 452-4062
(360) 452-4189
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
CO61077409
WA
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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