Blake, Emma Bryanne

Blake, Emma Bryanne is an individual health care provider with primary practice located at 4455 Ne Highway 20 , Corvallis OR 97330-9695. She recently has only one registered license in Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent, which is considered as her primary health care specialty. Blake, Emma Bryanne can be contacted via phone (541) 758-5900.

Contact Information

Primary practice address
4455 Ne Highway 20 Corvallis OR 97330-9695
Phone: (541) 758-5900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent 163WP0807X 201710072 Oregon

Profile Details

NPI number 1275159006
LBN Legal business name Blake, Emma Bryanne
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2020
Last updated Jun 17th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275159006 NPPES
Oregon Other 201710072 OREGON STATE BOARD OF NURSING

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