Provider Demographics
NPI:1992588446
Name:BLANDING, CIERRA LASHA'
Entity type:Individual
Prefix:MRS
First Name:CIERRA
Middle Name:LASHA'
Last Name:BLANDING
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CIERRA
Other - Middle Name:LASHA'
Other - Last Name:WASHINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:20725 WOOD QUAY DR UNIT 336
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-7073
Mailing Address - Country:US
Mailing Address - Phone:757-206-3686
Mailing Address - Fax:
Practice Address - Street 1:19455 DEERFIELD AVE STE 306
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8102
Practice Address - Country:US
Practice Address - Phone:703-729-5010
Practice Address - Fax:703-729-5833
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260021212255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer