Provider Demographics
NPI:1700110541
Name:BLATTNER, FLORA G (ARNP)
Entity type:Individual
Prefix:
First Name:FLORA
Middle Name:G
Last Name:BLATTNER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32205 40TH PL SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2451
Mailing Address - Country:US
Mailing Address - Phone:253-874-0154
Mailing Address - Fax:
Practice Address - Street 1:12333 NE 130TH LN
Practice Address - Street 2:SUITE 320
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7467
Practice Address - Country:US
Practice Address - Phone:425-899-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-27
Last Update Date:2009-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60013183363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care