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Individual

CHRISTINA RUTH BLATCHFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
4506 SE KING RD, MILWAUKIE, OR 97222-5233
(503) 659-1337
(503) 659-6411
Mailing address
4506 SE KING RD, MILWAUKIE, OR 97222-5233
(503) 659-1337
(503) 659-6411

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9307
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D9307
STATE LICENSE
OR
Enumeration date
07/25/2009
Last updated
07/25/2009
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