Kent William Blakely
Rheumatology
1909 214th St Se Ste 211
Bothell
, Washington 98021-4418
Kent William Blakely
Rheumatology
1909 214th St Se Ste 211
Bothell
, Washington 98021-4418
(425) 252-6642
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About
Features
Specialties
- Rheumatology
Languages spoken
- English
Location
First Address
- Kent William Blakely
- 1728 W Marine View Dr Ste 110
- Everett, WA
- Zip : 98201-2094
- Fax : (425) 252-6642
- Phone : (425) 259-4041
Second Address
- Kent William Blakely
- 1909 214th St Se Ste 211
- Bothell, WA
- Zip : 98021-4418
- Phone : (425) 248-2626
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RR0500X | Rheumatology | G162755 | CA |
| Y | 207RR0500X | Rheumatology | MD60640236 | WA |
National Provider Identifier
| NPI | 1134222458 |
|---|---|
| Provider Name | Kent William Blakely |
| First Address | Everett, WA 98201-2094 |
| Second Address | Bothell, WA 98021-4418 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/09/2006 |
| Last Update Date | 07/07/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| E89758 | (02) | |
| MD60640236 | STATE LICENSE (01) | WA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.