Provider Demographics
NPI:1770012403
Name:BLAUD, JUSTINE AURORE-MARIE (RN, CNM)
Entity Type:Individual
Prefix:MS
First Name:JUSTINE
Middle Name:AURORE-MARIE
Last Name:BLAUD
Suffix:
Gender:F
Credentials:RN, CNM
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Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:206-764-0502
Mailing Address - Fax:206-764-0516
Practice Address - Street 1:2018 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-4711
Practice Address - Country:US
Practice Address - Phone:360-852-9092
Practice Address - Fax:360-397-4368
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2021-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WARN60679910163WM0102X
WAAP61201395367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn