Individual
LINNEA BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3909 SE 70TH AVE, PORTLAND, OR 97206-2525
(503) 777-2278
Mailing address
340 TERRELL RD, SAN ANTONIO, TX 78209-5918
(210) 323-3055
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
06/02/2014
Last updated
06/02/2014
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