Organization
OREGON TLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JELENA BLACKBURN M.D., N.D. (VICE PRESIDENT)
(541) 255-1213
Entity
Organization
Contact information
Practice address
132 E BROADWAY, SUITE 716, EUGENE, OR 97401-3143
(541) 255-1213
Mailing address
132 E BROADWAY, SUITE 716, EUGENE, OR 97401-3143
(541) 255-1213
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
22132
OR
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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