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1366735227
ERIC JOHN BLICKENSTAFF
CORVALLIS, OR
NPI
1366735227
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: OR L4669)
Enumeration Date
2011-05-25
Last Update Date
2011-05-25
Business Address
ERIC JOHN BLICKENSTAFF L.C.S.W.
891 NW GRANT AVE
CORVALLIS, OR 97330-4539
Phone number: 503-708-6190
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Mailing Address
ERIC JOHN BLICKENSTAFF L.C.S.W.
4067 DAVIDSON ST SE
ALBANY, OR 97322-6325
Phone number: 503-708-6190
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