Blake, Edward Spencer

Blake, Edward Spencer is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Blake, Edward Spencer can be contacted via phone (503) 494-7772.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011
Phone: (503) 494-7772
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Neurology 2084N0400X MD219524 Oregon
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 76695-20 Wisconsin

Profile Details

NPI number 1780204875
LBN Legal business name Blake, Edward Spencer
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2020
Last updated Jul 5th, 2024 - about 2 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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