Individual
BLAIR UPDIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(971) 206-5202
Mailing address
1929 SE 114TH PL, PORTLAND, OR 97216-3668
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
400946
OR
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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