Provider Demographics
NPI:1578254835
Name:BLANSHAN, RUGER BURRIS (CPHT)
Entity Type:Individual
Prefix:
First Name:RUGER
Middle Name:BURRIS
Last Name:BLANSHAN
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-3222
Mailing Address - Country:US
Mailing Address - Phone:541-451-8020
Mailing Address - Fax:541-451-8027
Practice Address - Street 1:30 E OAK ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-3222
Practice Address - Country:US
Practice Address - Phone:541-451-8020
Practice Address - Fax:541-451-8027
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCPT-0014472183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician