Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michael Gregory Blackburn, MD

Individual provider Internal Medicine Physician · NPI 1063429652

Michael Gregory Blackburn, MD is an Internal Medicine Physician in Puyallup, Washington. Licensed in Washington. Registered with an NPI since 2006.

Licensed in
WA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

201 15th Ave SW Ste C
Puyallup, WA 98371-7495
Phone: (253) 841-4243
Fax: (253) 864-9452
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD00019306 (WA)

Record details

NPI number1063429652
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 3, 2006
Last updated in NPPESJuly 18, 2019
Mailing address201 15th Ave Sw Ste C, Puyallup, WA 98371-7495

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