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Organization

CHRISTOPHER A. BLAKE, MD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER ALAN BLAKE M.D. (OWNER)
(503) 472-0423
Entity
Organization

Contact information

Practice address
355 SE BAKER ST, MCMINNVILLE, OR 97128-6039
(503) 472-0423
Mailing address
355 SE BAKER ST, MCMINNVILLE, OR 97128-6039
(503) 472-0423

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200001052
RAILROAD MEDICARE
OR
05
228452
OR
Enumeration date
05/30/2007
Last updated
06/25/2009
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