Trenatty E. Blackwell, L.M.P.
Individual provider Active NPI Other Technician · Port Townsend, WA
NPI 1457547085 · NPPES record last updated Mar 21, 2013
Key facts
- NPI
- 1457547085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Technician 247200000X
- License
- MA000015607 (WA)
- Practice address
- 1634 Franklin St
Port Townsend, WA 98368-8123 - Phone
- (360) 301-6435
- NPI assigned
- Sep 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| MA000015607 | WA | MD | Other Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | MA000015607 | WA | Yes |
Addresses
Primary practice location
1634 Franklin St
Port Townsend, WA 98368-8123
Mailing address
PO Box 1614
Port Townsend, WA 98368-0110
Phone (360) 301-6435
Other providers in Port Townsend, WA
- Vitaliy Berezhnoy
- Matthew Patrick Berryman
- Katherine Biccum
- Rachel Lynn Bickling
- Heather Anne Blackmore
- James Clayton Blair III
- Katrina Blair
- Patricia Ann Bolen
- Susan F Bone O'Brien
- Macie Ann Booker
All providers in Port Townsend, WA · Other Technician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2013. 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.