PRIDEAUX-BLODGETT LLC NPI 1023431095

NPI Information

  • NPI: 1023431095
  • Provider Name: PRIDEAUX-BLODGETT LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Doing Business As: PACIFIC NORTHWEST PRIMARY CARE
  • CLIA Number: 50D2096326
  • Address: 1818 S UNION AVE
    SUITE 2A
    TACOMA, WA
    ZIP 98405
  • Phone: (253) 473-7637

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NPI Details

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyAP30003968WASHINGTONYes

What is NPI?

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This page was last updated on: 11/21/2025

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