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General NPI Number Information
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NPI Number | 1659466969
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Entity Type | Individual
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Provider Name | MINDY L BLASKI MD
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 3216 NE 45TH PL STE 106
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City | SEATTLE
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State | WA
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Zip | 98105-4028
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Country | US
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Telephone | 206-526-0210
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Fax | 206-526-0221
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Provider Business Mailing Address
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Address Line | 2023 26TH AVE E
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City | SEATTLE
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State | WA
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Zip | 98112-3043
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Country | US
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Telephone | 206-850-4232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | MD00018121
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G36982
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License Number State | CA
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