Individual
BLAINE MENON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
Mailing address
UW OFFICE OF GME 1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD61631944
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
04/02/2019
Last updated
07/03/2025
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