Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD60015842 | WA |
NPI | 1003929027 |
---|---|
Provider Name | Dr. Matthew S Blessing |
First Address | Seattle, WA 98145-5095 |
Second Address | Kent, WA 98032-2721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 10/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0239195 | L&I (01) | WA |
1003929027 | (05) | WA |