Individual
MR. MICHAEL ALLEN BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.P.R.N., P.M.H.N.P.
Contact information
Practice address
10101 SE MAIN ST STE 3001, PORTLAND, OR 97216-2458
(503) 261-5953
(503) 261-5954
Mailing address
PO BOX 92900, PORTLAND, OR 97292-0900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200950064NP
OR
363L00000X
Nurse Practitioner
AP60105167
WA
Other
Enumeration date
12/04/2009
Last updated
03/17/2018
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