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:
Health care specialties
| Specialty | Code | License # | 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 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457300550 | NPPES |
| Oregon | MEDICAID | 028386 |
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