Provider Demographics
NPI:1609138452
Name:BLAIS, PIERRE EMMANUEL (MD)
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:EMMANUEL
Last Name:BLAIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11027 MERIDIAN AVE N STE 100
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-1705
Mailing Address - Country:US
Mailing Address - Phone:206-365-4492
Mailing Address - Fax:206-368-3456
Practice Address - Street 1:11027 MERIDIAN AVE N STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-1705
Practice Address - Country:US
Practice Address - Phone:206-365-4492
Practice Address - Fax:206-368-3456
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10043076207R00000X
MO2015016238207RG0100X
WA60821860207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine