RICHARD W. BLAKE


Address: 3600 E Wickersham Way, Wasilla, AK 99654
Phone: 9073735950

RICHARD W. BLAKE (NPI# 1740235829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1740235829
Entity Type Individual
Full Name RICHARD W. BLAKE
Credential PA-C
Practice Address 3600 E Wickersham Way
Wasilla
AK 99654
Practice Telephone 9073735950
Practice Fax Number 9073735954
Mailing Telephone 9073735950
Mailing Fax Number 9073735954
Enumeration Date 2006-05-24
Last Update Date 2019-10-09
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers
Y 363AM0700X Physician Assistant
Specialization: Medical
PADA482 AK Physician Assistants & Advanced Practice Nursing Providers
N 363AM0700X Physician Assistant
Specialization: Medical
482 AK Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AK DEA NUMBER MB0593726 01

Other Providers RICHARD BLAKE

NPI Name Taxonomy Address Enumeration
1174650071 Richard Gary Blake Technician/Technologist 21835 Ventura Blvd, Woodland Hills, CA 91364-1838 2007-02-27
1972666774 Richard Daniel Blake Chiropractor 8 Glen Road, Powerhouse Mall, W Lebanon, NH 03784 2006-12-19
1295358356 Richard Andrew Blake Pharmacist 800 Glenwood Ave Se, Atlanta, GA 30316-1814 2020-05-24
1912921867 Richard Wayne Blake Dentist 2701 Park Dr, Suite #1, Clearwater, FL 33763-1021 2006-07-26
1699702308 Richard Alan Blake Internal Medicine 1401 Harrodsburg Rd, Suite A-300, Lexington, KY 40504-3751 2006-06-27
1770559924 Richard Lawrence Blake Podiatrist 900 Hyde St, San Francisco, CA 94109-4806 2006-02-27

Office Location

Street Address 3600 E WICKERSHAM WAY
City WASILLA
State AK
Zip Code 99654

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104317098 Melissa E San Roman Hearing Instrument Specialist 3600 E Wickersham Way, Wasilla, AK 99654-7550 2018-05-25
1134523855 Cottonwood Creek Clinic LLC Internal Medicine 3600 E Wickersham Way, Wasilla, AK 99654-7550 2014-10-09
1952659237 Jodie H Escot Hearing Instrument Specialist 3600 E Wickersham Way, Wasilla, AK 99654-7550 2012-08-17
1124376405 Raleen A Mccourry Hearing Instrument Specialist 3600 E Wickersham Way, Wasilla, AK 99654-7550 2012-08-17
1396093670 James O Staengel Hearing Instrument Specialist 3600 E Wickersham Way, Wasilla, AK 99654-7550 2012-08-17
1831447119 Otto Inc Hearing Instrument Specialist 3600 E Wickersham Way, Wasilla, AK 99654-7550 2012-08-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1003426784 Colleen Maggie Newcity Case Manager/Care Coordinator 851 Westpoint Suite 310, Wasilla, AK 99654 2020-08-06
1659995884 Amy M Lowe Peer Specialist 1363 W Spuce Ave, Wasilla, AK 99654 2020-06-03
1922648690 Achieve Medical Alaska LLC Clinic/Center 1981 E Palmer, Suite 230, Wasilla, AK 99654 2020-01-10
1588205538 Juan Carlos Garcia Physician Assistant 950 East Bogard Road, Suite 103, Wasilla, AK 99654 2019-10-01
1427610864 Sharon Webb Counselor 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 2019-07-06
1306401864 Logan Lee Cook Peer Specialist 2953 E Fairview Loop, Wasilla, AK 99654 2019-05-09
1053883595 Moose Creek Medical Clinic LLC Nurse Practitioner 2341 S. Fern St., Suite 300, Wasilla, AK 99654 2018-12-21
1487124962 Melissa A Stevens Massage Therapist 2201 W That Rd, Wasilla, AK 99654 2018-11-28
1609359561 Audrey E Beers Midwife 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 2018-09-07
1093297418 Karlee Janine Mccorry Occupational Therapist 613 S Knik-goose Bay Rd, Wasilla, AK 99654 2018-09-01
Find all providers in zip 99654

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912549098 Craig Michael Brumagin Physician Assistant 4961 E Mayflower Ln, Wasilla, AK 99654-7708 2019-10-10
1528503687 Northwoods Family Medicine, Inc Physician Assistant 1301 E. Palmer-wasilla Hwy, #400, Wasilla, AK 99654 2016-12-28
1669898474 Louis Michael Smith Physician Assistant 22301 W Alsop Rd, Wasilla, AK 99623-5023 2014-03-17
1083701858 Gerald Edward Manning II Physician Assistant 5050 Dunbar, Suite D, Wasilla, AL 99654 2006-10-05
1427049238 Scott William Schafer Physician Assistant 3066 E Meridian Park Loop, Capstone Urgent Care, Wasilla, AK 99654-7372 2005-11-01
1043738461 Nathan Fitzgerald Physician Assistant 22301 W Alsop Rd, Wasilla, AK 99623-5023 2017-09-06
1194119313 Adrian Kristin Giani Physician Assistant 1700 E Bogard Rd Ste 102, Wasilla, AK 99654-6563 2015-03-25
1629461488 David Arthur Physician Assistant 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 2015-03-17
1922498781 Matthew Loudon Physician Assistant 3331 E Meridian Park Loop, Wasilla, AK 99654-7294 2015-02-02
1548426471 Leah M Bramer Physician Assistant 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 2008-07-30
Find all providers in WASILLA

Competitor

Search similar providers

City WASILLA
Zip Code 99654

Improve Information

Please comment or provide details below to improve the information on RICHARD W. BLAKE.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches