Individual
JAY L BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
920 COUNTRY CLUB RD STE 140A, EUGENE, OR 97401-6024
(971) 915-8585
(503) 362-8435
Mailing address
1793 13TH ST SE, SALEM, OR 97302-2541
(503) 362-8385
(503) 362-8435
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10042189
OR
363L00000X
Nurse Practitioner
Primary
RN2265898
MA
Other
Enumeration date
09/10/2010
Last updated
06/10/2026
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