Dana Blackham, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD00019644 Issued in WA

Practice address

9776 Holman Rd NW
Suite 108
Seattle, WA 98117-2000

Phone

(206) 362-9508

Fax

(206) 362-1502

NPI assigned

Jan 30, 2007

Last updated

Jul 17, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dblackham605511@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Obhg Washington, PC

  • Obstetrics & Gynecology Physician
  • Silverdale, WA
  • NPI 1962729525

  Single Specialty

  NPD
• Obstetrix Medical Group of Washington Inc PS

  • Maternal & Fetal Medicine Physician
  • Seattle, WA
  • NPI 1861599573

  Single Specialty

  NPD
• Providence Health & Services - Washington

  dba PMG NW WA In Home Primary Care/Clearview

  • General Practice Physician
  • Snohomish, WA
  • NPI 1770877227
  NPD
• Providence Health & Services- Washington

  dba PMG NW Wa

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715

  Single Specialty

  NPD
• Seattle Nuclear Medicine-Ultrasound Associates

  • Radiology Clinic/Center
  • Seattle, WA
  • NPI 1265506349

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468713600000",
    "number": "1356487029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9776 HOLMAN RD NW",
            "address_2": "SUITE 108",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981172000",
            "telephone_number": "206-362-9508",
            "fax_number": "206-362-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9776 HOLMAN RD NW",
            "address_2": "SUITE 108",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981172000",
            "telephone_number": "206-362-9508",
            "fax_number": "206-362-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKHAM",
        "first_name": "DANA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00019644",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "WA",
            "license": "MD00019644",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "B398",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1940105",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "B398",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara J Blackburn, MC. LMHC
• Jack Archer Blackburn, LMP
• Rebecca Blackburn, LMP
• Timothy Alan Blackburn
• Kathryn E Blacken, PT
• Lauren Villasenor Blackham, ND
• Matthew David Blackham
• Heidi R. Blackie, OTR/L, CHT
• Christopher Craig Blackmore
• Emily Blackmore, RN

• Obstetrics & Gynecology Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Obstetrics & Gynecology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.