Provider Demographics
NPI:1730184706
Name:BLATTNER, RENEE C (LMHC)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:C
Last Name:BLATTNER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2606
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98213-0606
Mailing Address - Country:US
Mailing Address - Phone:425-355-9614
Mailing Address - Fax:425-355-1959
Practice Address - Street 1:518 PECKS DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-4405
Practice Address - Country:US
Practice Address - Phone:425-355-9614
Practice Address - Fax:425-355-1959
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005291101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health