# DR. JONATHAN M. BLATT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1699749804
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | MD16764 | OR | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | MD16764 | OR | Yes |

## Other

- **Enumeration date:** 02/14/2006
- **Last updated:** 11/24/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 009907 | — | OR |
| 01 | — | 050038330 | RR MEDICARE | OR |
| 05 | — | 8291734 | — | WA |