Individual
DR. STEVEN JAMES BLACKTHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
725 S WAHANNA RD, SEASIDE, OR 97138-7735
(503) 717-7000
Mailing address
725 S WAHANNA RD, SEASIDE, OR 97138-7735
(503) 717-7000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD 04851
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068957
—
OR
01
—
MD 04851
MEDICAL LICENSE
OR
Enumeration date
03/10/2006
Last updated
03/07/2023
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