Basic Information
| Provider Information | |||||||||
| NPI: | 1225442924 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BLUM | ||||||||
| FirstName: | KARA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4018 N MISSISSIPPI AVE | ||||||||
| Address2: | APT 211 | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972271697 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152902872 | ||||||||
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| Practice Location | |||||||||
| Address1: | 19075 NW TANASBOURNE DR | ||||||||
| Address2: | |||||||||
| City: | HILLSBORO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971245860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036848252 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2014 | ||||||||
| LastUpdateDate: | 04/23/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.