Individual
DR. JESSE GREENBLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 768-5111
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
247191
NY
208M00000X
Hospitalist Physician
Primary
MD158641
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500650075
—
OR
Enumeration date
05/30/2007
Last updated
11/09/2020
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