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1215414198
DEREK JAMES BLANKENSHIP
PENDLETON, OR
NPI
1215414198
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: OR 4367AT)
Enumeration Date
2018-07-24
Last Update Date
2018-07-24
Business Address
DEREK JAMES BLANKENSHIP
1815 SW EMIGRANT AVE
PENDLETON, OR 97801-1843
Phone number: 541-519-0679
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Mailing Address
DEREK JAMES BLANKENSHIP
1815 SW EMIGRANT AVE
PENDLETON, OR 97801-1843
Phone number: 541-519-0679
Copy
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