Gwyneth Blattau, MD

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

MD60271577 Issued in WA

Practice address

12519 N Division St
Suite 6
Spokane, WA 99218-1389

Phone

(509) 290-6149

Fax

(855) 474-9086

NPI assigned

Jan 10, 2007

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

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  NPD
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  • NPI 1780854885
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1932258522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12519 N DIVISION ST",
            "address_2": "SUITE 6",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181936",
            "telephone_number": "509-290-6149",
            "fax_number": "855-474-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12519 N DIVISION ST",
            "address_2": "SUITE 6",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181389",
            "telephone_number": "509-290-6149",
            "fax_number": "855-474-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATTAU",
        "first_name": "GWYNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "MD60271577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Blanchard
• Lacie G Bland, M.D.
• Morrie M Bland, CD
• Natalie Lynn Blashill, LMP
• Samantha Gaetana-Nania Blatner
• Erin Blau, DNP, MPH, FNP-BC
• Jessica Rose Blazivic
• John William Bleakmore
• Michelle Marie Bleek
• Allison Blehm, RN

• Medical Specialty Clinic/Center in Spokane, WA
• Providers in Spokane, WA by specialty
• Medical Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.