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Contact Information

BLAKE GORNOWICZ, MD
1700 E 19TH STREET
THE DALLES, OR97058
 Phone: 541-296-1111
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for BLAKE GORNOWICZ · (Male)

NPI Number 1548363732
Status Active
Credentials MD
Entity Individual
Enumeration date 09/06/2006
Last updated 12/11/2013 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2004018445
Hospital affiliation(s)
  • GRANDE RONDE HOSPITAL - (Critical Access)
    900 SUNSET DRIVE
    LA GRANDE, OR 97850
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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