Provider Demographics
NPI:1427863331
Name:BLANCHARD, ANNE ELIZABETH (PSS, CRM)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:ELIZABETH
Last Name:BLANCHARD
Suffix:
Gender:X
Credentials:PSS, CRM
Other - Prefix:
Other - First Name:TEMPEST
Other - Middle Name:ELIZABETH
Other - Last Name:BLANCHARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSS, THW
Mailing Address - Street 1:442 NE SIMPSON ST APT C
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-3173
Mailing Address - Country:US
Mailing Address - Phone:503-501-1741
Mailing Address - Fax:
Practice Address - Street 1:442 NE SIMPSON ST APT C
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-3173
Practice Address - Country:US
Practice Address - Phone:503-501-1741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-08
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR112859175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist