Individual
DR. CELESTE BLANKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
(541) 266-4589
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
(541) 266-4589
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4868
OH
207Q00000X
Family Medicine Physician
Primary
DO165427
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407812365
GROUP NPI NORTH BEND MEDICAL CENTER
OR
01
—
16113
GROUP MEDICAID NORTH BEND MEDICAL CENTER
OR
05
—
500671822
—
OR
01
—
93-0635514
GROUP TAX FOR BILLING NORTH BEND MEDICAL CENTER
OR
01
—
DO165427
OREGON MEDICAL BOARD
OR
01
—
R0000WFBTV
GROUP MEDICARE NORTH BEND MEDICAL CENTER
OR
Enumeration date
01/25/2006
Last updated
06/30/2014
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