Individual
MS. MARY LOUISE BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP, PMHNP-BC
Contact information
Practice address
11740 SW 68TH PKWY STE 200, TIGARD, OR 97223-9058
(971) 352-6971
Mailing address
1907 NW 6TH ST, HERMISTON, OR 97838-1148
(972) 825-2575
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10006006
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2023150476
NM
363LP2300X
Primary Care Nurse Practitioner
0375722
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3017279-01
—
TX
05
—
77056396
—
NM
Enumeration date
08/02/2006
Last updated
02/10/2026
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