MS. ELIZABETH MIYU BLAKE (NPI# 1639103237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639103237 |
| Entity Type | Individual |
| Full Name | MS. ELIZABETH MIYU BLAKE |
| Other Name | ELIZABETH LARSON |
| Credential | ARNP |
| Practice Address |
301 N 10th Ave Pasco WA 99301-5480 |
| Mailing Address |
128 Woodland Ave Port Townsend WA 98368-5049 |
| Practice Telephone | 5095472429 |
| Mailing Telephone | 2064224035 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN00118189 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP30003638 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 9620097 | 05 | |
| DEA | MB0867171 | 01 | |
| WA | RN LICENSE | RN00118189 | 01 |
| WA | ARNP LICENSE | AP30003638 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 501 -- 5th Ave, Seattle, WA 98104 | 2062964600 | |
| 9951 Mickelberry Rd Nw, Ste 101, Silverdale, WA 983838309 | 3606929362 | 3606926214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619329943 | Elizabeth Blake | Counselor | 3412 S 49th Ave, Omaha, NE 68106-4010 | 2016-07-11 |
| 1629435359 | Elizabeth Blake | Dietitian, Registered | 16301 Eagle Ln, Huntington Beach, CA 92649-2715 | 2016-01-26 |
| 1780076224 | Elizabeth Blake | Registered Nurse | 9314 Forest Hill Blvd Ste 204, Wellington, FL 33411-6577 | 2015-02-20 |
| 1497914048 | Elizabeth Blake | Physical Medicine & Rehabilitation | 8721 Bradmoor Dr, Bethesda, MD 20817-3636 | 2008-06-08 |
| 1053429290 | Elizabeth Anne Blake | Counselor | 2711 Pinedale Rd Ste A, Greensboro, NC 27408-4706 | 2006-08-28 |
| 1174512289 | Elizabeth W. Blake | Pharmacist | 715 Sumter St, Room 314a, Columbia, SC 29208-0001 | 2005-10-20 |
| 1811504897 | Elizabeth Blake | Social Worker | 8501 Lasalle Rd, Suite 115, Towson, MD 21286 | 2020-09-24 |
| 1063809663 | Elizabeth Blake | Case Manager/Care Coordinator | 333 Church Street, Wrangell, AK 99929 | 2015-04-21 |
| 1295152908 | Elizabeth Helo Blake | Nurse Practitioner | 576 N Avenue G, Ste E, Crowley, LA 70526-4441 | 2014-03-20 |
| 1114109006 | Elizabeth Blake | Counselor | 14 Fordham Rd, Allston, MA 02134-3006 | 2007-12-03 |
| Street Address |
301 N 10TH AVE |
| City | PASCO |
| State | WA |
| Zip Code | 99301-5480 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710504550 | Kayshuv Enterprises | Pharmacy | 7505 Sandifur Pkwy, Suite 102, Pasco, WA 99301 | 2020-06-27 |
| 1558883157 | Cecilia Carmen Asenjo | Registered Nurse | 715 W Court Street, Pasco, WA 99301 | 2017-07-14 |
| 1528451085 | Felix Ramos | Dentist | 7425 Wrigley Dr Ste 201, Pasco, WA 99301 | 2015-03-09 |
| 1861896631 | Tri-cities Community Health | General Practice | 1801 E Sheppard St, Pasco, WA 99301 | 2014-10-22 |
| 1649617861 | Thompson.ferguson,steinhart. James.pllc | Dentist | 6525 Burden Blvd, Pasco, WA 99301 | 2013-05-29 |
| 1598008880 | Thompson. Ferguson. Steinhart. James, Pllc | Dentist | 6525 Burden Boulevard, Pasco, WA 99301 | 2013-04-04 |
| 1639421720 | Comprehensive Healthcare | Community/Behavioral Health | 2715 Saint Andrews Loop, Suite C, Pasco, WA 99301 | 2012-10-12 |
| 1497065395 | Danny M Trapp Jr. | Counselor | 516 W. Margaret, Pasco, WA 99301 | 2010-10-14 |
| 1740510486 | Columbia Basin College | Dental Hygienist | 2600 N 20th Ave, Ms T-1, Pasco, WA 99301 | 2009-12-31 |
| 1417286386 | Wanda Marie Good | Surgery | 1200 N 14th Ave Ste 255, Pasco, WA 99301 | 2009-12-23 |
| Find all providers in zip 99301 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326569021 | Spencer Rorie Crihfield | Nurse Practitioner | Po Box 1452, Pasco, WA 99301-1223 | 2017-07-03 |
| 1467505263 | Cynthia Susan Ironside | Nurse Practitioner | 9605 Sandifur Pkwy, Pasco, WA 99301-8028 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200509 | Megan Maureen Bauer | Nurse Practitioner | 6057 California Ave Sw, Seattle, WA 98136-1612 | 2020-09-17 |
| 1265077960 | Hannah Thornton | Nurse Practitioner | 4800 Sand Point Way Ne # Fa.2114, Seattle, WA 98105-3901 | 2019-11-17 |
| 1598319683 | Jennifer Lynn Bryson | Nurse Practitioner | 8738 Falls Ave Se, Snoqualmie, WA 98065-9610 | 2019-07-28 |
| 1013494434 | Lindsay Bascom Brown | Nurse Practitioner | 12815 120th Ave Ne Ste A, Kirkland, WA 98034-3003 | 2018-07-27 |
| 1518475631 | Sarah Remorca Agtarap | Nurse Practitioner | 175 1st Pl Nw Ste A, Issaquah, WA 98027-2746 | 2018-01-11 |
| 1518470137 | Bear Creek Pediatrics | Nurse Practitioner | 105 W 8th Ave Ste 7035, Spokane, WA 99204-2313 | 2017-11-06 |
| 1871005298 | Alexis Anne Abel | Nurse Practitioner | 15650 Ne 24th St Ste C, Bellevue, WA 98008-2460 | 2017-10-25 |
| 1912427386 | Melinda Ehren Kratzig | Nurse Practitioner | 4800 Sand Point Way Ne # Msoa9220, Seattle, WA 98105-3901 | 2017-06-26 |
| 1245766880 | Jennifer Jean Baker | Nurse Practitioner | 904 7th Ave Fl 3, Seattle, WA 98104-1132 | 2017-05-02 |
| 1194196485 | Lara Subhash | Nurse Practitioner | 3326 160th Ave Se Ste 450, Bellevue, WA 98008-6418 | 2015-10-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.