Blayne A Standage is a Surgery in Portland, Oregon. Blayne A Standage practices all healthcare services and medical treatments related to Surgery. The NPI Number for Blayne A Standage is 1164410874. The last update date is 2011-03-04.
Blayne A Standage's current location address is 1130 Nw 22nd Ave, Portland, Oregon. You can contact this provider via phone number 5032264325 and fax number 5032275024. The mailing address for Blayne A Standage is 1130 Nw 22nd Ave, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Blayne A Standage |
|---|---|
| Address | 1130 Nw 22nd Ave, Portland, Oregon |
| Phone Number | 5032264325 |
| Fax Number | 5032275024 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1164410874 |
|---|---|
| Provider Enumeration Date | 2005-10-07 |
| Last Updated Date | 2011-03-04 |
Provider Mailing Address Detail
| Address | 1130 Nw 22nd Ave |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972102900 |
| Phone Number | 5032264325 |
| Fax Number | 5032275024 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | MD12970 |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| MD12970 | STATE LICENSE | ||
| 161513 | OR | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Blayne A Standage?
The Blayne A Standage has been issued the NPI (National Provider Identifier) 1164410874 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Blayne A Standage?
The Blayne A Standage is physically situated at 1130 Nw 22Nd Ave, in the city of Portland, state of OR, with the postal code 972102900.
What is the Blayne A Standage's specialty and taxonomy code?
The Blayne A Standage's specialty is Surgery, and the corresponding taxonomy code is 208600000X.
On what date was the 1164410874 assigned to Blayne A Standage?
The Blayne A Standage was issued its 1164410874 on 2005-10-07, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the Blayne A Standage's information last updated?
The Blayne A Standage's information was last updated on 2011-03-04.