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Contact Information

JONATHAN M BLATT, MD
6542 SE LAKE RD.
SUITE 202
MILWAUKIE, OR97222
 Phone: 503-654-5636
 Fax: 503-654-5638
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for JONATHAN M BLATT · (Male)

NPI Number 1699749804
Status Active
Credentials MD
Entity Individual
Enumeration date 02/14/2006
Last updated 11/24/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # MD16764
  • OR Medicaid 009907
  • WA Medicaid 8291734
  • OR Other 050038330 RR MEDICARE
Hospital affiliation(s)
  • PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL - (Critical Access)
    810 12TH STREET
    HOOD RIVER, OR 97031
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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