Individual
MARCY BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1011 COMMERCIAL ST NE STE 110, SALEM, OR 97301-1036
(503) 983-9900
Mailing address
9460 SW BAYOU DR, MCMINNVILLE, OR 97128-8660
(971) 241-8549
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10007864
OR
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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