Individual
JOHN STEPHEN BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.AC
Contact information
Practice address
8283 SW BARBUR BLVD, PORTLAND, OR 97219-2871
(503) 244-1330
Mailing address
232 NE 69TH AVE, PORTLAND, OR 97213-5614
(503) 251-2083
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00171
OR
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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