# OREGON TLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174871552
- **Authorized official:** DR. JELENA BLACKBURN M.D., N.D. (VICE PRESIDENT)
- **Authorized official phone:** (541) 255-1213

## Contact information

- **Practice address:** 132 E BROADWAY, SUITE 716, EUGENE, OR 97401-3143
- **Practice address phone:** (541) 255-1213
- **Mailing address:** 132 E BROADWAY, SUITE 716, EUGENE, OR 97401-3143
- **Mailing address phone:** (541) 255-1213

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 22132 | OR | Yes |

## Other

- **Enumeration date:** 08/16/2012
- **Last updated:** 08/16/2012