Trudy Bly, RN,CDE

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

RN60573521 Issued in WA

Practice address

1221 Highland Ave
Clarkston, WA 99403-2829

Phone

(509) 758-5511

Fax

(509) 254-0083

NPI assigned

Jun 20, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1679923767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 HIGHLAND AVE",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032829",
            "telephone_number": "509-758-5511",
            "fax_number": "509-254-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 HIGHLAND AVE",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032829",
            "telephone_number": "509-758-5511",
            "fax_number": "509-254-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLY",
        "first_name": "TRUDY",
        "credential": "RN,CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "WA",
            "license": "RN60573521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie R Black, SOCIAL WORKER
• Elizabeth Lefft Black, MD
• Jacob I. Blazzard, PA-C
• Blue Mountain Family Health PLLC
• Jace Blume
• Herbert Bohner, RPH
• Maggie Rosalie Bolon, LCSW
• Chad Ryan Bouterse, D.O.
• Megan McKenna Brame, RDH
• Sarah Rachel Bramell, RN

• Ambulatory Care Registered Nurse in Clarkston, WA
• Providers in Clarkston, WA by specialty
• Ambulatory Care Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.