Individual
CHRISTOPHER A. BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
355 SE BAKER ST, MCMINNVILLE, OR 97128-6039
(503) 472-0423
(503) 472-4325
Mailing address
355 SE BAKER ST, MCMINNVILLE, OR 97128-6039
(503) 472-0423
(503) 472-4325
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
10783
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200001052
RAILROAD MEDICARE
OR
05
—
228452
—
OR
01
—
930805004
TAX ID
—
Enumeration date
05/05/2006
Last updated
10/07/2008
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