Blake, Richard W.

Blake, Richard W. is an sole proprietor health care provider with primary practice located at 3600 E Wickersham Way , Wasilla AK 99654. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Blake, Richard W. can be contacted via phone (907) 373-5950.

Contact Information

Primary practice address
3600 E Wickersham Way Wasilla AK 99654
Phone: (907) 373-5950
Fax: (907) 373-5954
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 482 Alaska
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PADA482 Alaska

Profile Details

NPI number 1740235829
LBN Legal business name Blake, Richard W.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2006
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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