Individual
MR. DALLAS L BLENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7972 MAPLE AVE SE, SNOQUALMIE, WA 98065
(425) 888-4151
Mailing address
7972 MAPLE AVE SE, SNOQUALMIE, WA 98065
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CG60855379
WA
Other
Enumeration date
01/03/2019
Last updated
01/03/2019
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