OrganizationActive
Michael G. Blackburn, M.D. , Inc. P.s.
NPI 1285801480 · Primary Care Clinic/Center · Puyallup, WA
Provider details
- NPI number
- 1285801480
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Blackburn, Owner(253) 841-4243
- License
- MD00019306 (WA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
201 15th Ave Sw Ste C
Puyallup, WA 98371-7495
Phone: (253) 841-4243
Fax: (253) 864-9452
Street-level locationGet directions
Mailing address
201 15th Ave Sw Ste C
Puyallup, WA 98371-7495
Registry dates
- Enumerated
- 2008-05-15
- Last updated
- 2019-07-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.