DOUGLAS P BLACKALL

PORTLAND, OR
NPI1891885380
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207ZC0006X Pathology, Clinical Pathology
(Licence: OR  MD202871)
Additional Taxonomies207ZB0001X Pathology, Blood Banking & Transfusion Medicine
(Licence: OR  MD202871)
207ZB0001X Pathology, Blood Banking & Transfusion Medicine
(Licence: AR  C-7459)
207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine
(Licence: AR  C-7459)
Enumeration Date2006-10-13
Last Update Date2021-01-15
Business Address
DOUGLAS P BLACKALL MD
4805 NE GLISAN ST
PORTLAND, OR 97213-2933
Phone number: 503-215-6096
Mailing Address
DOUGLAS P BLACKALL MD
PO BOX 3395
PORTLAND, OR 97208-3395
Phone number: 503-215-6023