Provider Demographics
NPI:1902137953
Name:BLANCHFIELD, COURTNEY RAE (LMP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:RAE
Last Name:BLANCHFIELD
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 GRANT RD STE 1
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-5384
Mailing Address - Country:US
Mailing Address - Phone:509-884-4200
Mailing Address - Fax:509-884-4201
Practice Address - Street 1:304 GRANT RD STE 1
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5384
Practice Address - Country:US
Practice Address - Phone:509-884-4200
Practice Address - Fax:509-884-4201
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60116808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor