Blake, Thomas Joel
Blake, Thomas Joel is an sole proprietor health care provider with primary practice located at 721 N Pines Rd Suite 101, Spokane Valley WA 99206-5225. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Blake, Thomas Joel can be contacted via phone (509) 926-1234.Contact Information
Primary practice address
721 N Pines Rd Suite 101
Spokane Valley WA 99206-5225
Phone: (509) 926-1234
Fax: (509) 926-1701
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DE00010588 | Washington |
| Dental Providers / General Practice | 1223G0001X | 5226914-9921 | Utah |
| Dental Providers / General Practice | 1223G0001X | 5775 | Arizona |
Profile Details
| NPI number | 1992862593 |
|---|---|
| LBN Legal business name | Blake, Thomas Joel |
| Credentials | D.D.S., M.S.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 2nd, 2007 |
| Last updated | Aug 30th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992862593 | NPPES |
| Washington | MEDICAID | 5051255 |
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