Individual
DANA BLACKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9776 HOLMAN RD NW, SUITE 108, SEATTLE, WA 98117-2000
(206) 362-9508
(206) 362-1502
Mailing address
9776 HOLMAN RD NW, SUITE 108, SEATTLE, WA 98117-2000
(206) 362-9508
(206) 362-1502
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD00019644
WA
207VX0000X
Obstetrics Physician
MD00019644
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1940105
—
WA
01
—
B398
REGENCE BLUE SHIELD
WA
Enumeration date
01/30/2007
Last updated
07/17/2016
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