institution
Michael G. Blackburn, M.d. , Inc. P.s.
Primary Care Clinic/Center in Puyallup, Washington
NPI 1285801480

Michael G. Blackburn, M.d. , Inc. P.s. is a Primary Care Clinic/Center based in Puyallup, WA and is specialized in Primary Care. Michael G. Blackburn, M.d. , Inc. P.s. practices in Puyallup, WA. The NPI Number for Michael G. Blackburn, M.d. , Inc. P.s. is 1285801480 and holds a License No. MD00019306 (Washington).

The current practice location address for Michael G. Blackburn, M.d. , Inc. P.s. is 201 15Th Ave Sw Ste C, Puyallup, WA and can be reached out via phone at 253-841-4243 and via fax at 253-864-9452. You can also correspond with Michael G. Blackburn, M.d. , Inc. P.s. through the mailing address at 201 15TH AVE SW STE C, PUYALLUP, WA - 98371-7495 (mailing address contact number: 253-841-4243).

Location: 201 15Th Ave Sw Ste C, Puyallup, WA, 98371-7495
institution
Provider Profile Details
NPI Number
1285801480
Provider Name
Michael G. Blackburn, M.d. , Inc. P.s.
Credential
Provider Entity Type
Organization
Address
201 15Th Ave Sw Ste C, Puyallup, WA, 98371-7495
Phone Number
253-841-4243
Fax Number
253-864-9452
Provider Enumeration Date
05/15/2008
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1008895 05 WA
BL4674 01 WA REGENCE
110008458 01 RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
201 15Th Ave Sw Ste C
City
State
Zip
98371-7495
Phone Number
253-841-4243
Fax Number
253-864-9452
person
Provider Business Mailing Address Details
Address
201 15Th Ave Sw Ste C
City
State
Zip
98371-7495
Phone Number
253-841-4243
Fax Number
253-864-9452
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
MD00019306 (Washington)
Definition
Definition to come...
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