MEDICARE: MR. REESE J BLIEK P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA10004653	WA

General Provider Information

NPI Number	:	1811962442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. REESE J BLIEK P.A.

Provider Business Mailing Address
First Line	:	275 SE CABOT DR STE A3
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3740
Country	:	US
Telephone Number	:	360-682-5024
Fax Number	:	360-682-5749

Provider Business Practice Location Address
First Line	:	275 SE CABOT DR STE A3
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3740
Country	:	US
Telephone Number	:	360-720-8076
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	04/09/2021

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