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Contact Information

BLAIR PETERS
3181 SW SAM JACKSON PARK RD # L352A
PORTLAND, OR97239-3011
 Phone: 503-494-7824
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
 

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for BLAIR PETERS · (Male)

NPI Number 1871147876
Status Active
Credentials
Entity Individual
Enumeration date 07/29/2019
Last updated 04/28/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2019011349
  • OR License # 197514
Hospital affiliation(s)
  • OHSU HOSPITAL AND CLINICS - (Acute Care)
    3181 SW SAM JACKSON PARK ROAD
    PORTLAND, OR 97239
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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