EDWARD SPENCER BLAKE
Individual Provider (NPI-1)
Active
Psychiatry & Neurology, Neurology
Provider Information
- NPI Number
1780204875- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 3181 SW SAM JACKSON PARK RD, PORTLAND, OR, 972393011
- Phone
- (503) 494-7772
Specialties & Taxonomies
Psychiatry & Neurology, Neurology
License: WI #76695-20
Psychiatry & Neurology, Neurology
Primary License: OR #MD219524