Individual
GREGORY PHILIP BLOSSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4415 SW VERMONT ST, PORTLAND, OR 97219-1020
(503) 244-0570
(503) 244-0572
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61486
OR
225100000X
Physical Therapist
PT022811
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500710770
—
OR
Enumeration date
09/17/2014
Last updated
09/12/2016
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