Vivian L Blanco, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00036490 Issued in WA

Practice address

436 McPhee Rd SW
Olympia, WA 98502-5014

Phone

(360) 352-7779

Fax

(360) 352-5175

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1124112073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 MCPHEE RD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025014",
            "telephone_number": "360-352-7779",
            "fax_number": "360-352-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 MCPHEE RD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025014",
            "telephone_number": "360-352-7779",
            "fax_number": "360-352-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "VIVIAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00036490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillie Blair
• Kelli Jo Blaise, RN
• Ann Beth Blake, PHD
• Catherine Mary Blakely, MSPT
• Blanco Family Medicine, PLLC
• Andrew Blank, PT
• Christine K Blas, PT, DPT
• Kristyn Blocher
• Nathanael David Block
• Blossoming Dreams Inc.

• Family Medicine Physician in Olympia, WA
• Providers in Olympia, 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 Nov 27, 2007; 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.