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General NPI Number Information
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NPI Number | 1184271322
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Entity Type | Individual
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Provider Name | JOANNA BLONDEAU
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Gender | Female
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 14508 NE 20TH AVE STE 300
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City | VANCOUVER
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State | WA
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Zip | 98686-6418
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Country | US
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Telephone | 360-892-0208
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Fax |
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Provider Business Mailing Address
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Address Line | 5185 SW 175TH AVE
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City | BEAVERTON
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State | OR
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Zip | 97078-1779
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Country | US
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Telephone | 731-607-6473
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | AP60989611
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License Number State |
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