Provider Demographics
NPI:1407547425
Name:BLANCHARD, JONATHON WAYNE (ARNP, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:JONATHON
Middle Name:WAYNE
Last Name:BLANCHARD
Suffix:
Gender:M
Credentials:ARNP, FNP-C
Other - Prefix:MR
Other - First Name:JON
Other - Middle Name:
Other - Last Name:BLANCHARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:336 CHARDONNAY AVE
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-9515
Mailing Address - Country:US
Mailing Address - Phone:509-786-1576
Mailing Address - Fax:509-786-1574
Practice Address - Street 1:336 CHARDONNAY AVE
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350-9515
Practice Address - Country:US
Practice Address - Phone:509-786-1576
Practice Address - Fax:509-786-1574
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61453555363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner