Individual
MRS. DENISE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1303 PACIFIC AVE, EVERETT, WA 98201-4234
(425) 339-5419
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 258-3900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005577
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013333
—
WA
05
—
8479263
—
WA
Enumeration date
03/19/2007
Last updated
08/08/2017
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