Search › Washington › 363A00000X
Jacob Blazzard, PA-C
NPI 1326125485 · on the registry since 2006
Practice
- Address
- 1433 5th St
Clarkston, WA 99403 - Phone
- (509) 758-5141
- Fax
- (509) 758-5299
- Organisation at this address
- Integrated Dermatology Of Clarkston Pllc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363AM0700X
363A00000X
363AM0700X - Licence states on file
- WA, ID, WY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-08-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington