Individual
BLAKE HERBISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18520 101ST AVE NE, BOTHELL, WA 98011-3804
(425) 486-2727
Mailing address
18520 101ST AVE NE, BOTHELL, WA 98011-3804
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00011059
WA
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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