Individual
JEFFREY RAYMOND BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1875 GOLF COURSE RD S, SALEM, OR 97302-9622
(503) 585-4824
(503) 370-2545
Mailing address
16083 SW UPPER BOONES FERRY RD, STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 443-1402
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3662
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182199
—
OR
Enumeration date
11/30/2005
Last updated
10/29/2012
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