Blake Carter Osmundsen
Obstetrician & Gynecologist Gynecologist Female Pelvic Medicine and Reconstructive Surgeon
5050 Ne Hoyt St Suite 615
Portland
, Oregon 97213-2991
Blake Carter Osmundsen
Obstetrician & Gynecologist Gynecologist Female Pelvic Medicine and Reconstructive Surgeon
5050 Ne Hoyt St Suite 615
Portland
, Oregon 97213-2991
(503) 231-0484
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About
Features
Specialties
- Obstetrician & Gynecologist
- Female Pelvic Medicine and Reconstructive Surgeon
- Gynecologist
Languages spoken
- English
Location
First Address
- Blake Carter Osmundsen
- 5050 Ne Hoyt St Suite 615
- Portland, OR
- Zip : 97213-2991
- Fax : (503) 231-0484
- Phone : (503) 231-0407
Second Address
- Blake Carter Osmundsen
- 5050 Ne Hoyt St Suite 615
- Portland, OR
- Zip : 97213-2991
- Fax : (503) 231-0484
- Phone : (503) 231-0407
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207V00000X | Obstetrician & Gynecologist | MD17368 | OR |
| Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD17368 | OR |
| N | 207VG0400X | Gynecologist | MD00044007 | WA |
| N | 207VG0400X | Gynecologist | MD17368 | OR |
National Provider Identifier
| NPI | 1457300550 |
|---|---|
| Provider Name | Blake Carter Osmundsen |
| First Address | Portland, OR 97213-2991 |
| Second Address | Portland, OR 97213-2991 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/05/2006 |
| Last Update Date | 13/02/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 028386 | (05) | OR |
| E09124 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.