Individual
DR. BLAKE A NONWEILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 NE NEFF RD STE 200, BEND, OR 97701-4281
(541) 382-3344
(541) 322-2286
Mailing address
1650 NW NAITO PKWY, STE 185, PORTLAND, OR 97209-2535
(503) 525-7690
(503) 525-7652
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD19775
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077537
—
OR
Enumeration date
07/14/2006
Last updated
01/23/2020
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