Sandra Lee Blakeney-Butler
Individual provider Active NPI Licensed Practical Nurse · Enumclaw, WA
NPI 1265705180 · NPPES record last updated Feb 23, 2012
Key facts
- NPI
- 1265705180
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LP60144018 (WA)
- Practice address
- 40903 236TH Ave SE
Enumclaw, WA 98022-8606 - Phone
- (360) 825-6525
- NPI assigned
- Feb 23, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP60144018 | WA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP60144018 | WA | Yes |
Addresses
Primary practice location
40903 236TH Ave SE
Enumclaw, WA 98022-8606
Mailing address
40903 236TH Ave SE
Enumclaw, WA 98022-8606
Phone (360) 825-6525
Other providers in Enumclaw, WA
- Todd Alan Bergstrom
- Bethel House Afh LLC
- David R Bhaskar
- Nataliya Bilan
- David H Bishop
- Janelle Blakey
- Kacie M Blanchard
- Nancy E Block-Olexick
- Blue Barn Therapy Group, LLC
- Christopher D Bock
All providers in Enumclaw, WA · Licensed Practical Nurse in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.