Individual
DR. COLLIN MATTHEW BLATTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1815 E 19TH ST STE B, THE DALLES, OR 97058-3385
(541) 316-6575
(412) 108-9135
Mailing address
PO BOX 2430, THE DALLES, OR 97058-8022
(541) 316-6575
(541) 210-8913
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
PG172025
OR
207ND0101X
MOHS-Micrographic Surgery Physician
DO177547
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500753179
—
OR
Enumeration date
04/08/2015
Last updated
08/02/2023
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