Individual
JACOB BALINKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
3716 NE MLK BLVD, PORTLAND, OR 97212-1111
(503) 288-8066
Mailing address
5516 NE 45TH AVE, PORTLAND, OR 97218-1422
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
200542475RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
200750104NP
OR
Other
Enumeration date
09/04/2007
Last updated
11/01/2012
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