Healthcare Provider Details

I. General information

NPI: 1093621591
Provider Name (Legal Business Name): CAITLYN BLATT REMUND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLYN SUZANNE BLATT

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 NE 139TH ST
VANCOUVER WA
98686-2742
US

IV. Provider business mailing address

2211 NE 139TH ST
VANCOUVER WA
98686-2742
US

V. Phone/Fax

Practice location:
  • Phone: 360-487-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN60954948
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: