Provider Demographics
NPI:1104877109
Name:BLATNER, MICHAEL EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EUGENE
Last Name:BLATNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 50150
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015-0150
Mailing Address - Country:US
Mailing Address - Phone:425-228-5228
Mailing Address - Fax:425-228-5733
Practice Address - Street 1:16259 SYLVESTER RD SW
Practice Address - Street 2:#302
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3049
Practice Address - Country:US
Practice Address - Phone:206-241-5400
Practice Address - Fax:206-241-8591
Is Sole Proprietor?:No
Enumeration Date:2006-05-14
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD000309402082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB39396Medicare PIN