Individual
DR. GRIFFITH BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2520 CHERRY AVE, BREMERTON, WA 98310-4229
(360) 744-5804
(206) 965-4279
Mailing address
2520 CHERRY AVE, BREMERTON, WA 98310-4229
(360) 744-5804
(206) 965-4279
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
MD00029049
WA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD00029049
WA
207RP1001X
Pulmonary Disease Physician
MD00029049
WA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD00029049
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014390
—
WA
05
—
1115468
—
WA
Enumeration date
03/23/2006
Last updated
12/01/2020
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