Philip William Blair, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00034198 Issued in WA

Practice address

237 Michner St SW
Castle Rock, WA 98611-9612

Phone

(360) 635-0126

NPI assigned

Jun 13, 2008

Sex

Male

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1114187978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 MICHNER ST SW",
            "city": "CASTLE ROCK",
            "state": "WA",
            "postal_code": "986119612",
            "telephone_number": "360-635-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 MICHNER ST SW",
            "city": "CASTLE ROCK",
            "state": "WA",
            "postal_code": "986119612",
            "telephone_number": "360-635-0126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W 8th St",
            "address_2": "unit 205",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986603435",
            "country_code": "US",
            "telephone_number": "360-635-0126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "PHILIP",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-13",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00034198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Castle Rock Pharmacy Inc
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• Summer Noel Catlin, M.S.CCC-SLP

• Family Medicine Physician in Castle Rock, WA
• Providers in Castle Rock, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.