Individual
BLAKE GASSAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
727 W BURNSIDE ST, PORTLAND, OR 97209-3514
(503) 228-4618
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
10055026
OR
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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