Individual
BRUCE HENRY BLANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
164 NW MACLEAY BLVD, PORTLAND, OR 97210-3323
(503) 228-1253
(503) 228-1797
Mailing address
164 NW MACLEAY BLVD, PORTLAND, OR 97210-3323
(503) 228-1253
(503) 228-1797
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD09769
OR
Other
Enumeration date
09/12/2006
Last updated
07/08/2007
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