Individual
BLAKE A NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9300 SE 91ST AVE STE 200, HAPPY VALLEY, OR 97086-3762
(503) 261-1171
(503) 253-5989
Mailing address
9300 SE 91ST AVE STE 200, HAPPY VALLEY, OR 97086-3762
(503) 261-1171
(503) 253-5989
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA217352
OR
Other
Enumeration date
06/23/2022
Last updated
01/16/2025
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