Provider Demographics
NPI:1033358395
Name:BLOIS, ANDREA M (PT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:BLOIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 G ST
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-4019
Mailing Address - Country:US
Mailing Address - Phone:360-332-8167
Mailing Address - Fax:360-332-0931
Practice Address - Street 1:250 G ST
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98230-4019
Practice Address - Country:US
Practice Address - Phone:360-332-8167
Practice Address - Fax:360-332-0931
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010302174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist