Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Todd David Blakley, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1861405227

Todd David Blakley, PHYSICIANASSISTANT is a Physician Assistant in Vancouver, Washington. Qualified in 1996, 30 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
30
Licensed in
WA
In the registry since
2006
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Practice location Address checks out

14406 NE 20th Ave
Vancouver, WA 98686-1448
Phone: (360) 571-3053
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence WA PA10003448 (WA)

Record details

NPI number1861405227
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedAugust 15, 2006
Last updated in NPPESJuly 8, 2007
Mailing address3905 Nw 119th St, Vancouver, WA 98685-3593

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Vancouver