Individual
BLAINE FISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2655 NORTHWINDS PKWY, ALPHARETTA, GA 30009-2280
(770) 643-5619
Mailing address
1206 COMSTOCK ST, RICHLAND, WA 99352-4528
(208) 741-0447
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60701046
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP61257123
WA
Other
Enumeration date
12/27/2021
Last updated
04/28/2022
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