Healthcare Provider Details

I. General information

NPI: 1144894510
Provider Name (Legal Business Name): BLESSET ALEXANDER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date: 11/03/2022
Reactivation Date: 11/07/2022

III. Provider practice location address

1950 NW MYHRE RD FL 2
SILVERDALE WA
98383-7662
US

IV. Provider business mailing address

1950 NW MYHRE RD FL 2
SILVERDALE WA
98383-7662
US

V. Phone/Fax

Practice location:
  • Phone: 564-240-4155
  • Fax: 564-240-4177
Mailing address:
  • Phone: 564-240-4155
  • Fax: 564-240-4177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD.MD.70045798
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.MD.70045798
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: