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DESIRAE BLOOMQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3377 RIVERBEND DR, SPRINGFIELD, OR 97477-8803
(541) 222-6565
(541) 222-6567
Mailing address
442 S BLAKELEY ST, MONROE, WA 98272-2207

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60766318
WA
363L00000X
Nurse Practitioner
Primary
202108299NP-PP
OR
363LF0000X
Family Nurse Practitioner
AP60909323
WA

Other

Enumeration date
06/03/2018
Last updated
04/05/2022
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