Bloomquist, Melany K
Bloomquist, Melany K is an sole proprietor health care provider with primary practice located at 1590 Woodridge Dr Se , Port Orchard WA 98366-3818. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Bloomquist, Melany K can be contacted via phone (360) 871-5100.Contact Information
Primary practice address
1590 Woodridge Dr Se
Port Orchard WA 98366-3818
Phone: (360) 871-5100
Fax: (360) 871-5104
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 7314 | Washington |
Profile Details
| NPI number | 1902026834 |
|---|---|
| LBN Legal business name | Bloomquist, Melany K |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 25th, 2007 |
| Last updated | Jul 9th, 2007 - about 19 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 | 1902026834 | NPPES |
| Washington | Other | 57314 | WASHINGTON DENTAL SERVICE |
| Washington | MEDICAID | 5018981 | WASHINGTON DENTAL SERVICE |
| Washington | Other | 792442 | WASHINGTON DENTAL SERVICE |
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