Individual
MR. KIP BRYAN BLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
400 NE MOTHER JOSEPH PL, VANCOUVER, WA 98664-3200
(360) 514-4004
Mailing address
24001 NE 128TH ST, BRUSH PRAIRIE, WA 98606-3227
(360) 892-0093
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00148877
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30006439
WA
Other
Enumeration date
07/12/2006
Last updated
11/07/2009
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