BRUCE GRAGG BLACKSTONE (NPI# 1891760211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891760211 |
| Entity Type | Individual |
| Full Name | BRUCE GRAGG BLACKSTONE |
| Credential | M.D. |
| Practice Address |
625 9th Ave Suite 210 Longview WA 98632-2465 |
| Practice Telephone | 3605013400 |
| Practice Fax Number | 3604236862 |
| Mailing Telephone | 3605013400 |
| Mailing Fax Number | 3604236862 |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2010-09-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | MD00020762 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1131101 | 05 | |
| OR | 195560 | 05 |
| Street Address |
625 9TH AVE SUITE 210 |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285632919 | Patrick M Lassen | Urology | 625 9th Ave, Suite 120, Longview, WA 98632-2464 | 2005-07-07 |
| 1356640312 | Brittney Higa | Physical Therapist | 625 9th Ave, Suite 220, Longview, WA 98632-2464 | 2011-03-16 |
| 1891012316 | Providence Health & Services - Oregon | Clinic/Center | 625 9th Ave, Suite 120, Longview, WA 98632-2465 | 2010-04-23 |
| 1043414741 | Tony C Lin | Orthopaedic Surgery | 625 9th Ave, Ste 210, Longview, WA 98632-2464 | 2007-06-14 |
| 1063623429 | Aaron C Varney | Occupational Therapist | 625 9th Ave, Suite 220, Longview, WA 98632 | 2007-05-25 |
| 1750481453 | Longview Surgical Center LLC | Clinic/Center | 625 9th Ave, Suite #110, Longview, WA 98632 | 2006-09-22 |
| 1588688402 | John Thomas Mansfield | Urology | 625 9th Ave, Suite 120, Longview, WA 98632-2464 | 2006-07-26 |
| 1366492795 | David Maligro | Physician Assistant | 625 9th Ave, Ste 210, Longview, WA 98632-2465 | 2006-05-10 |
| 1245205228 | David Michael Black | Orthopaedic Surgery | 625 9th Ave, Ste 210, Longview, WA 98632-2465 | 2006-02-22 |
| 1225003213 | William Taylor Turner | Orthopaedic Surgery | 625 9th Ave, Ste 210, Longview, WA 98632-2465 | 2006-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437589181 | Charles Larson | Orthopaedic Surgery | 2431 Park Hill Dr, Longview, WA 98632-5785 | 2013-11-16 |
| 1316990088 | Anthony J Lauder | Orthopaedic Surgery | 625 9th Ave Ste 210, Longview, WA 98632-2465 | 2006-05-17 |
| 1003865072 | Longview Orthopedic Associates, Pllc | Orthopaedic Surgery | 625 - 9th Ave., Ste. 210, Longview, WA 98632-2465 | 2006-05-08 |
| 1417948084 | Stephen G Littlejohn | Orthopaedic Surgery | 323 E Hawkins Pkwy Ste A, Longview, TX 75605-7905 | 2005-11-02 |
| 1427049089 | Kenneth E Reesor | Orthopaedic Surgery | 709 Hollybrook Dr Ste 3401, Longview, TX 75605-2412 | 2005-11-02 |
| 1467069013 | Ortholonestar, Pllc | Orthopaedic Surgery | 925 W Loop 281, Longview, TX 75604-2918 | 2020-09-28 |
| 1124292263 | Charles Grooters | Orthopaedic Surgery | 323 E Hawkins Pkwy Ste A, Longview, TX 75605-7905 | 2008-04-19 |
| 1184808677 | Jay M Stanley | Orthopaedic Surgery | 700 E Marshall Ave, Longview, TX 75601-5580 | 2007-12-20 |
| 1043414741 | Tony C Lin | Orthopaedic Surgery | 625 9th Ave, Ste 210, Longview, WA 98632-2464 | 2007-06-14 |
| 1225169279 | Peter Kung | Orthopaedic Surgery | 625 9th Ave Ste 210, Longview, WA 98632-2465 | 2007-03-08 |
| Find all providers in LONGVIEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.