Provider Demographics
NPI:1003082926
Name:TRUEBLOOD, JILL (LMT, LAMT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:TRUEBLOOD
Suffix:
Gender:F
Credentials:LMT, LAMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1092 AENEAS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:TONASKET
Mailing Address - State:WA
Mailing Address - Zip Code:98855-9507
Mailing Address - Country:US
Mailing Address - Phone:509-486-0306
Mailing Address - Fax:
Practice Address - Street 1:311 S WHITCOMB AVE
Practice Address - Street 2:
Practice Address - City:TONASKET
Practice Address - State:WA
Practice Address - Zip Code:98855-9507
Practice Address - Country:US
Practice Address - Phone:509-486-0306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021830174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist