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PRIDEAUX-BLODGETT LLC NPI 1023431095


NPI Information

NPI: 1023431095
Provider Name: PRIDEAUX-BLODGETT LLC

Doing Business As: PACIFIC NORTHWEST PRIMARY CARE

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 50D2096326

Address:
1818 S UNION AVE
SUITE 2A
TACOMA, WA
ZIP 98405
Phone: (253) 473-7637
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PRIDEAUX-BLODGETT LLC is a family nurse practitioner in Tacoma, WA. PRIDEAUX-BLODGETT LLC NPI is 1023431095. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Pacific Northwest Primary Care.

The provider's business location address is:

1818 S UNION AVE
SUITE 2A
TACOMA, WA
ZIP 98405-953
Phone: (253) 473-7637
Fax: (253) 671-8472

The provider's authorized official is Becky Blodgett .
The authorized official title is Np and has the following contact phone number (253) 473-7637.

The CLIA number assigned to this NPI record is 50D2096326 - other - arnp with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2014 and was last updated on 1/28/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamilyAP30003968WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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