Provider Demographics
NPI:1225442924
Name:BLUM, KARA ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:ELIZABETH
Last Name:BLUM
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4018 N MISSISSIPPI AVE
Mailing Address - Street 2:APT 211
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1697
Mailing Address - Country:US
Mailing Address - Phone:215-290-2872
Mailing Address - Fax:
Practice Address - Street 1:19075 NW TANASBOURNE DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5860
Practice Address - Country:US
Practice Address - Phone:503-684-8252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2015-04-23
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant