Individual
HOLLY A BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
32014 LITTLE BOSTON RD NE, KINGSTON, WA 98346-9734
(360) 297-9601
(360) 297-9614
Mailing address
32014 LITTLE BOSTON RD NE, KINGSTON, WA 98346-9734
(360) 297-9601
(360) 297-9614
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN00138315
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50-1839
MEDICARE FQHC
WA
05
—
7094964
—
WA
05
—
7094972
—
WA
05
—
7407703
—
WA
Enumeration date
09/06/2007
Last updated
09/06/2007
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