Blake, Martha L

Blake, Martha L is an sole proprietor health care provider with primary practice located at I-5 Between Hwy 217 And I-205 , Tualatin OR 97062-9773. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychoanalyst, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Blake, Martha L can be contacted via phone (503) 691-6391.

Contact Information

Primary practice address
I-5 Between Hwy 217 And I-205 Tualatin OR 97062-9773
Phone: (503) 691-6391
Fax: (503) 691-8451
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychoanalyst 102L00000X 0003361 New York
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1824 Oregon

Profile Details

NPI number 1083632129
LBN Legal business name Blake, Martha L
Credentials PSYCHOLOGIST, NCPSYT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2006
Last updated Dec 16th, 2013 - about 12 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 1083632129 NPPES
New York Other 0003361 LICENSE

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