Osmundsen, Blake Carter

Osmundsen, Blake Carter is an sole proprietor health care provider with primary practice located at 5050 Ne Hoyt St Suite 615, Portland OR 97213-2991. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is his primary health care specialty. Osmundsen, Blake Carter can be contacted via phone (503) 231-0407.

Contact Information

Primary practice address
5050 Ne Hoyt St Suite 615 Portland OR 97213-2991
Phone: (503) 231-0407
Fax: (503) 231-0484
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD17368 Oregon
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X MD00044007 Washington
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X MD17368 Oregon
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X MD17368 Oregon

Profile Details

NPI number 1457300550
LBN Legal business name Osmundsen, Blake Carter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 8th, 2006
Last updated Feb 13th, 2019 - about 5 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 1457300550 NPPES
Oregon MEDICAID 028386

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