Individual
MR. LARRY STEVEN BLANK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1 WESTERN OREGON SERVICE UNIT, CHEMAWA INDIAN HEALTH CENTER, SALEM, OR 97305-1111
(503) 304-7600
(503) 304-7678
Mailing address
131 NW 20TH ST, STE D, NEWPORT, OR 97365
(503) 304-7600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9431
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270030
—
OR
Enumeration date
01/18/2006
Last updated
07/08/2007
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