Individual
EDWARD SPENCER BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7772
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7772
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
76695-20
WI
2084N0400X
Neurology Physician
Primary
MD219524
OR
Other
Enumeration date
04/20/2020
Last updated
06/24/2025
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