# GREGARY M. BLACKNER INC. P.S.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326146754
- **Authorized official:** DR. GREGARY M BLACKNER MD (OWNER)
- **Authorized official phone:** (360) 786-1297

## Contact information

- **Practice address:** 403 BLACK HILLS LN SW, B, OLYMPIA, WA 98502-8600
- **Practice address phone:** (360) 786-1297
- **Practice address fax:** (360) 534-9043
- **Mailing address:** 403 BLACK HILLS LN SW, STE B, OLYMPIA, WA 98502-8600
- **Mailing address phone:** (360) 786-1297
- **Mailing address fax:** (360) 534-9043

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 26210 | WA | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/30/2010