Individual provider Active NPI

Deborah Blazzard, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Pullman, WA
National Provider Identifier
1659639854
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60438303 Issued in WA
Practice address
825 SE Bishop Blvd Ste 201
Pullman, WA 99163-5517
Phone
(509) 339-2394
Fax
(509) 715-2128
NPI assigned
Apr 25, 2012
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP-1155A ID
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60438303 WA Primary

Addresses

Primary practice location

825 SE Bishop Blvd Ste 201
Pullman, WA 99163-5517

Mailing address

840 SE Bishop Blvd
Suite 101
Pullman, WA 99163-5502
Phone (509) 332-6139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140718002010 WA Practitioner - Nurse Practitioner 6709002256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

825 SE Bishop Blvd
Pullman, WA 99163-5517

835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone (509) 332-2541

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-1155AIDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District #1-a of Whitman County CurrentSince Apr 18, 2024 Accepting new patients
Public Hospital District #1-a of Whitman County CurrentSince Apr 18, 2024 Accepting new patients
Public Hospital District #1-a of Whitman County Past Accepting new patients
Public Hospital District # 1-a Past Accepting new patients

Locations

1420 S Blaine St
Ste 5
Moscow, ID 83843
Phone (208) 882-2247

825 SE Bishop Blvd
Ste 140
Pullman, WA 99163
Phone (509) 334-4498

825 SE Bishop Blvd
Ste 201
Pullman, WA 99163
Phone (509) 336-7577

825 SE Bishop Blvd
Ste 401
Pullman, WA 99163
Phone (509) 336-7720

835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541

840 SE Bishop Blvd
Ste 101
Pullman, WA 99163
Phone (509) 332-6139

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1659639854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 SE BISHOP BLVD",
            "address_2": "SUITE 101",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635502",
            "telephone_number": "509-332-6139",
            "fax_number": "509-332-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD STE 201",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "509-339-2394",
            "fax_number": "509-715-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZZARD",
        "first_name": "DEBORAH",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "NP-1155A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60438303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

Verify at the official NPI Registry.