Jacob I. Blazzard, PA-C
Jacob I. Blazzard, PA-C is a Physician Assistant in Clarkston, Washington. Qualified in 2005, 21 years ago. Practices with Integrated Dermatology of Clarkston PLLC, a 6-clinician group and accepts Medicare assignment. Licensed in Idaho, Washington and Wyoming.
- Years since qualifying
- 21
- Licensed in
- ID, WA, WY
- In the registry since
- 2006
- Specialties on file
- 4
What do these letters mean?
- PA-C — Physician Assistant, Certified
- A physician assistant who holds current national certification.
Practice location Address checks out
1433 5th StClarkston, WA 99403-2714
Phone: (509) 758-5141
Fax: (509) 758-5299
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence PA.PA.60099484 (WA) |
|---|---|
| Medical Physician Assistant | Taxonomy 363AM0700X · Licence PA60099484 (WA) |
| Physician Assistant | Taxonomy 363A00000X · Licence PA-1221 (ID) |
| Medical Physician Assistant | Taxonomy 363AM0700X · Licence 361 (WY) |
Record details
| NPI number | 1326125485 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA-C |
| Sole proprietor | No |
| NPI enumerated | November 1, 2006 |
| Last updated in NPPES | August 4, 2026 |
| Certification date | August 4, 2026 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2005 (21 years in practice) |
| Group practice | Integrated Dermatology Of Clarkston Pllc — 6 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Clarkston
-
Mr. Tyler Lee Anderson, PA-C
1119 Highland Ave Ste 4, Clarkston, WA 99403-2836 · (509) 254-0080
-
Carolyn Jean Shoemaker, PA-C
1433 5th St, Clarkston, WA 99403-2714 · (509) 758-5141