Individual
BLAKE THEDINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
27 COLWELL ST, PORT HADLOCK, WA 98339-0897
(360) 385-9310
(360) 379-8826
Mailing address
PO BOX 897, PORT HADLOCK, WA 98339-0897
(360) 385-9310
(360) 379-8826
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60231824
WA
Other
Enumeration date
08/20/2011
Last updated
02/10/2015
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