Individual
LUCY ANNE BLOEDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4020 SW IOWA ST, PORTLAND, OR 97221-3423
(503) 577-9504
Mailing address
4020 SW IOWA ST, PORTLAND, OR 97221-3423
(503) 577-9504
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
20200141NP-PP
OR
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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