Provider Demographics
NPI:1215356183
Name:SIMPSON&BLOOMQUIST DDS, PLLC
Entity Type:Organization
Organization Name:SIMPSON&BLOOMQUIST DDS, PLLC
Other - Org Name:KARLA M BLOOMQUIST, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BLOOMQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-857-4114
Mailing Address - Street 1:2727 HOLLYCROFT ST
Mailing Address - Street 2:#280W
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1305
Mailing Address - Country:US
Mailing Address - Phone:253-857-4114
Mailing Address - Fax:253-857-4119
Practice Address - Street 1:2727 HOLLYCROFT ST
Practice Address - Street 2:#280W
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1305
Practice Address - Country:US
Practice Address - Phone:253-857-4114
Practice Address - Fax:253-857-4119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10113332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment