Individual
DR. DARIN G BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11216 SUNRISE BLVD E, # 3-106, PUYALLUP, WA 98374-8848
(253) 848-5951
(253) 864-8954
Mailing address
3908 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-5951
(253) 864-8954
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00040368
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0159725
LABOR AND INDUSTRIES
WA
01
—
080189997
MEDICARE RAIL ROAD
WA
01
—
7772362
AETNA
WA
05
—
8299778
—
WA
01
—
8934627
LABOR AND INDUSTRIES VOC
WA
01
—
9868BL
REGENCE RIDER
WA
Enumeration date
06/14/2006
Last updated
01/25/2016
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