Individual
JASON M BLEAZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
8503 W CLEARWATER AVE STE A, KENNEWICK, WA 99336-3100
(509) 943-6565
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD60231221
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2020602
—
WA
Enumeration date
09/12/2011
Last updated
07/30/2026
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