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1316050602
GREGARY M BLACKNER
OLYMPIA, WA
NPI
1316050602
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WA MD00026210)
Enumeration Date
2006-08-17
Last Update Date
2021-05-25
Business Address
GREGARY M BLACKNER M.D.
1617 SUMMIT LAKE SHORE RD NW
OLYMPIA, WA 98502-9437
Phone number: 801-682-8190
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Mailing Address
GREGARY M BLACKNER M.D.
PO BOX 721
KAYSVILLE, UT 84037-0721
Phone number: 801-682-8190
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