Individual
JENNIFER SUZANNE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSCIAL THERAPIST
Contact information
Practice address
4560 SE INTERNATIONAL WAY, CONSONUS REHAB SERVICES, MILWAUKIE, OR 97222
(971) 206-5140
(971) 206-5209
Mailing address
4560 SE INTERNATIONAL WAY, MILWAUKIE, OR 97222
(971) 206-5140
(971) 206-5209
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5243
OR
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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