Healthcare Provider Details

I. General information

NPI: 1154234714
Provider Name (Legal Business Name): LAQUINNA BLAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: QUINNA MATHIS

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 W CHELAN AVE
SPOKANE WA
99205-3520
US

IV. Provider business mailing address

1433 W CHELAN AVE
SPOKANE WA
99205-3520
US

V. Phone/Fax

Practice location:
  • Phone: 509-994-7455
  • Fax:
Mailing address:
  • Phone: 509-994-7455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberBDC.BD.70182874
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: