Individual
BLAKE WARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
450 PORT ORCHARD BLVD, PORT ORCHARD, WA 98366-4705
(360) 895-2224
Mailing address
637 SW BIRCH RD, PORT ORCHARD, WA 98367-9330
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60200322
WA
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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