Individual
CAROL ELIZABETH BLENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3930 SE DIVISION ST, PORTLAND, OR 97202-1643
(503) 418-3900
(503) 418-3939
Mailing address
2055 NW SAVIER ST., SUITE 201, PORTLAND, OR 97209-1773
(503) 494-8417
(503) 346-8021
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD19941
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81880
—
OR
Enumeration date
11/09/2005
Last updated
09/20/2017
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