Provider Demographics
NPI:1831570191
Name:BLANSCETT, TIMOTHY SETH (ARNP)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:SETH
Last Name:BLANSCETT
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 GAGE BLVD
Mailing Address - Street 2:STE 203
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-8650
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:
Practice Address - Street 1:1100 GOETHALS DR
Practice Address - Street 2:STE D
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3300
Practice Address - Country:US
Practice Address - Phone:509-942-3185
Practice Address - Fax:509-946-1850
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60092106163W00000X
WAAP60598011363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse