Most Relevant Information
Provider Data
| NPI Number: | 1003835539 |
| Provider Name: | HERBERT ALDEN BLAKE OD |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 953 |
Most Important Dates
| Enumeration Date: | 07/18/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
OPTOMETRY CLINIC
MADIGAN ARMY MEDICAL CENTER
TACOMA
WA
984310001
Practice Location Phone/Fax
| Phone: | 2539682790 |
| Fax: | 2539684677 |
Provider Mailing Location
12914 130TH AVENUE CT E
PUYALLUP
WA
983744825
Provider Mailing Phone/Fax
| Phone: | 2538400780 |
| Fax: |