Organization
GREGARY M. BLACKNER INC. P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGARY M BLACKNER MD (OWNER)
(360) 786-1297
Entity
Organization
Contact information
Practice address
403 BLACK HILLS LN SW, B, OLYMPIA, WA 98502-8600
(360) 786-1297
(360) 534-9043
Mailing address
403 BLACK HILLS LN SW, STE B, OLYMPIA, WA 98502-8600
(360) 786-1297
(360) 534-9043
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26210
WA
Other
Enumeration date
09/20/2006
Last updated
08/30/2010
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