Melissa Anne Blackburn

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

9300 NE Oak View Dr
Vancouver, WA 98662-6157

Phone

(360) 675-2211

NPI assigned

Feb 20, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1083170591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 NW 106TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854871",
            "telephone_number": "971-218-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 NE OAK VIEW DR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626157",
            "telephone_number": "360-675-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter K Black, MD
• Rebecca Sarah Rose Black
• Sara Black, LMT
• Stephen Rockwell Black, LMHCA
• Timothy Black, PA
• Jennifer Rebecca Blackman, P.T.A
• Kevoy Blackwood
• Kabiah Ann Blain
• Jackie Hyman Blair, MED.,CDP
• Rebecca Kaye Blair, LICWSA

• Case Manager/Care Coordinator in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Case Manager/Care Coordinator in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.