Healthcare Provider Details

I. General information

NPI: 1316708076
Provider Name (Legal Business Name): BLANCHEI BALOY ARREOLA LP00057493
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4821 S KENT DES MOINES RD # B341
KENT WA
98032-4212
US

IV. Provider business mailing address

4821 S KENT DES MOINES RD # B341
KENT WA
98032-4212
US

V. Phone/Fax

Practice location:
  • Phone: 425-899-3300
  • Fax: 425-899-1740
Mailing address:
  • Phone: 425-899-3300
  • Fax: 425-899-1740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberLP00057493
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberLP00057493
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: