Provider Demographics
NPI:1235729187
Name:MITCHELL BLAKNEY PT, PLLC
Entity Type:Organization
Organization Name:MITCHELL BLAKNEY PT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:BLAKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:253-318-6665
Mailing Address - Street 1:3716 44TH ST CT
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8277
Mailing Address - Country:US
Mailing Address - Phone:253-318-6665
Mailing Address - Fax:
Practice Address - Street 1:5202 OLYMPIC DR #100
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8277
Practice Address - Country:US
Practice Address - Phone:253-318-6665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty