NPI 1215414198 · live from the CMS NPI Registry
Derek James Blankenship
Optometrist in Pendleton, OR. National Provider Identifier 1215414198, active.
NPI record
| NPI | 1215414198 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1815 Sw Emigrant Ave, Pendleton, OR 97801 |
| Practice phone | 541-519-0679 |
| Enumerated | July 24, 2018 |
| Last updated | July 24, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 4367AT (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.