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Individual

JASON BLANKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8122
(503) 494-1542
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8122
(503) 494-1542

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD215444
OR
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD215444
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
11/19/2018
Last updated
07/12/2023
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