MEDICARE: ROBERT CORY BLICKENSTAFF PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT00009330	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	179487	OTHER	WA	LABOR & IND.
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760478762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT CORY BLICKENSTAFF PT

Provider Business Mailing Address
First Line	:	13023 NE HIGHWAY 99
Second Line	:	SUITE 7 PMB 109
City	:	VANCOUVER
State	:	WA
Zip	:	98686-2767
Country	:	US
Telephone Number	:	360-600-2272
Fax Number	:	877-362-9612

Provider Business Practice Location Address
First Line	:	717 NE 61ST ST
Second Line	:	SUITE 203
City	:	VANCOUVER
State	:	WA
Zip	:	98665-8753
Country	:	US
Telephone Number	:	360-600-2272
Fax Number	:	877-362-9612

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2005
Last Update Date	:	04/06/2011

Similar Medicare Providers

1770415960 — NOVIS INITIIS PSYCHOTHERAPY PLLC
Practice Location Address:

717 NE 61ST ST STE 206
VANCOUVER, WA
98665-8753

Practice Phone: 720-295-5853
Practice Fax: 866-466-5083

1831511849 — DR. ANSON L SERVICE SR. PSY.D., LMHC
Practice Location Address:

717 NE 61ST ST , #202
VANCOUVER, WA
98665-8753

Practice Phone: 360-718-6548
Practice Fax: 360-718-6554

1609290931 — ROBIN LACOSSE LMP
Practice Location Address:

717 NE 61ST ST , 102
VANCOUVER, WA
98665-8753

Practice Phone: 319-325-5579
Practice Fax:

1255722211 — KRISTY BRACKEN LMP
Practice Location Address:

717 NE 61ST ST , SUITE 102
VANCOUVER, WA
98665-8753

Practice Phone: 360-433-9480
Practice Fax:

1104203876 — AMANDA JANAY BARBER MASSAGE THERAPIST
Practice Location Address:

717 NE 61ST ST , #100
VANCOUVER, WA
98665-8753

Practice Phone: 503-974-6463
Practice Fax:

1811364227 — ADVENTURE LEARNING AND ASSESSMENT
Practice Location Address:

717 NE 61ST ST , #202
VANCOUVER, WA
98665-8753

Practice Phone: 360-718-6548
Practice Fax: 360-718-6554

Directions to “ ROBERT CORY BLICKENSTAFF PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.