Individual
DR. MELANY K BLOOMQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1590 WOODRIDGE DR SE, PORT ORCHARD, WA 98366-3818
(360) 871-5100
(360) 871-5104
Mailing address
1590 WOODRIDGE DR SE, PORT ORCHARD, WA 98366-3818
(360) 871-5100
(360) 871-5104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7314
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5018981
—
WA
01
—
57314
WASHINGTON DENTAL SERVICE
WA
01
—
792442
UNITED CONCORDIA
WA
Enumeration date
04/25/2007
Last updated
07/09/2007
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