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Active NPI 1326125485 Individual Practitioner Male Practitioner

Jacob I. Blazzard , PA-C

Physician Assistant • Clarkston, WA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Jacob Blazzard, PA-C is a certified Physician Assistant practicing in Clarkston, WA. With approximately 21 years of clinical experience since completing medical education in 2005, Jacob Blazzard delivers high-quality medical care to the local community at 1433 5TH ST.

Jacob Blazzard is affiliated with Integrated Dermatology Of Clarkston Pllc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1433 5th St

Clarkston, WA 994032714

Telephone 5097585141
Fax 5097585299
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Clarkston, WA

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
21 Yrs +2.0 yrs vs City Avg
City Avg: 19.0 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
4 Specialists

Practicing in Clarkston, WA (3774 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
57.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Blazzard (21 Years) 21 Yrs
Clarkston Specialty Average (19.0 Years) 19.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths
1,283 348 $15.00 $5.76
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
602 553 $107.33 $48.19
17000 Destruction of skin growth
510 461 $127.48 $49.02
11102 Tangential biopsy of single skin lesion
376 358 $185.00 $85.61
99213 Established patient office or other outpatient visit, typically 15 minutes
353 321 $170.00 $77.01
99202 New patient office or other outpatient visit, typically 20 minutes
200 200 $135.00 $61.48
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
135 135 $206.96 $94.82
11103 Biopsy of related skin growth, each additional growth
70 56 $95.00 $42.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
48 44 $236.98 $107.43
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm
47 45 $558.30 $258.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
42 42 $311.43 $139.10
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm
36 33 $451.94 $105.06
69100 Biopsy of ear
24 23 $176.88 $69.99
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth
17 17 $332.06 $150.25
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm
17 14 $328.24 $149.07
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm
13 12 $273.08 $123.22

Medical Specialties & State Licenses

CMS Verified: 2026-08-04
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License WA PA.PA.60099484

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

State License WA PA60099484

Definition to come...

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License ID PA-1221

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

State License WY 361

Definition to come...

Hospital & Practice Group Affiliations

Integrated Dermatology Of Clarkston Pllc

1433 5th St, Clarkston, WA 994032714

Phone: 5097585141

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1053313411

Doctor of Medicine (M.D.)

Jennifer Nicholas , FNP

Nurse Practitioner

NPI 1083978837

Family Nurse Practitioner

Carolyn Shoemaker , PA-C

Physician Assistant

NPI 1477856649

Physician Assistant (Certified)

NPI 1841269248

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Business Mailing Address August 04, 2026

Registered at 4700 EXCHANGE CT STE 110, BOCA RATON, FL 334314450 (Tel: 5619480291)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2026

Physician Assistant (License #PA60099484 in WA)

📍
Updated Practice Location August 24, 2022

Registered at 1433 5TH ST, CLARKSTON, WA 994032714 (Tel: 5097585141)

📍
Updated Business Mailing Address August 24, 2022

Registered at 901 RACHEL ST, TROY, ID 838716002 (Tel: 2083102777)

📍
Updated Practice Location February 20, 2019

Registered at 623 S MAIN ST STE 1, MOSCOW, ID 838432983 (Tel: 2088822011)

📍
Updated Business Mailing Address February 20, 2019

Registered at 700 S MAIN ST, MOSCOW, ID 838433046 (Tel: 2088824511)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 20, 2019

Physician Assistant (License #PA-1221 in ID)

NPI Profile Active December 31, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location December 31, 2014

Registered at 1205 SE PROFESSIONAL MALL BLVD, SUITE 104, PULLMAN, WA 991635423 (Tel: 5093322605)

📍
Updated Business Mailing Address December 31, 2014

Registered at 1205 SE PROFESSIONAL MALL BLVD, SUITE 104, PULLMAN, WA 991635423 (Tel: 5093322605)

👤
Provider Name / Credentials Updated December 31, 2014

Recorded as JACOB BLAZZARD, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 31, 2014

Physician Assistant (License #PA60099484 in WA)

🟢
Initial NPI Registration & Enumeration November 01, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1326125485
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 01, 2006
Last Update: August 04, 2026
Sole Proprietor: No

Mailing Address

4700 Exchange Ct Ste 110

Boca Raton, FL 334314450

Phone: 5619480291

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.