Individual
GLENN TRUEBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
26 NW IRVING, BEND, OR 97701
(541) 385-5203
(541) 385-4724
Mailing address
965 SW EMKAY DR, STE 200, BEND, OR 97702-3598
(541) 385-5203
(541) 385-4724
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1200
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084157
—
OR
Enumeration date
03/23/2007
Last updated
05/02/2016
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