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Individual

ALEX BLAZE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
16515 MERIDIAN E STE 101, PUYALLUP, WA 98375-6251
(253) 466-3178
Mailing address
16515 MERIDIAN E STE 101, PUYALLUP, WA 98375-6251
(253) 466-3178

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60630103
WA

Other

Enumeration date
05/19/2016
Last updated
07/11/2024
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