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Individual

EMMA BLACKWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSN RN

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(303) 513-6518
Mailing address
2560 CHAR CIR NW, SALEM, OR 97304-1541
(303) 513-6518

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
202209580RN
OR
376K00000X
Nurse's Aide
201900109CNA
OR

Other

Enumeration date
06/11/2021
Last updated
07/18/2022
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