Blanke, Charles David

Blanke, Charles David is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd Mailcode L586, Portland OR 97239-3011. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Blanke, Charles David can be contacted via phone (503) 494-1556.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Mailcode L586 Portland OR 97239-3011
Phone: (503) 494-1556
Fax: (503) 494-3257
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X MD21402 Oregon

Profile Details

NPI number 1639187198
LBN Legal business name Blanke, Charles David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Jul 17th, 2007 - about 17 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 1639187198 NPPES
Oregon MEDICAID 130063

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