Healthcare Provider Details

I. General information

NPI: 1356252977
Provider Name (Legal Business Name): EUNYOUNG YEON BLANDFORD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2303 KILDANE WAY SE
OLYMPIA WA
98501-3068
US

IV. Provider business mailing address

2303 KILDANE WAY SE
OLYMPIA WA
98501-3068
US

V. Phone/Fax

Practice location:
  • Phone: 253-617-5460
  • Fax:
Mailing address:
  • Phone: 253-617-5460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number61314612
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: