Provider Demographics
NPI:1851429195
Name:BLAKE, ROBBIN (LMP)
Entity Type:Individual
Prefix:MS
First Name:ROBBIN
Middle Name:
Last Name:BLAKE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 SW 157TH ST APT 105
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2536
Mailing Address - Country:US
Mailing Address - Phone:206-478-7980
Mailing Address - Fax:206-243-5185
Practice Address - Street 1:2366 EASTLAKE AVE E STE 424
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3392
Practice Address - Country:US
Practice Address - Phone:206-478-4980
Practice Address - Fax:206-243-5185
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020509225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist