Individual
DR. KEVIN PATRICK BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
(503) 494-4661
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
(503) 494-4661
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A117484
CA
207L00000X
Anesthesiology Physician
Primary
MD195468
OR
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
A117484
CA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
D78083
MD
Other
Enumeration date
05/16/2011
Last updated
10/16/2023
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