Provider Demographics
NPI:1457690620
Name:FORSTER-BLOUIN, SHARON LEE (DVM)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LEE
Last Name:FORSTER-BLOUIN
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-6413
Mailing Address - Country:US
Mailing Address - Phone:541-753-2287
Mailing Address - Fax:541-754-0008
Practice Address - Street 1:620 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6413
Practice Address - Country:US
Practice Address - Phone:541-753-2287
Practice Address - Fax:541-754-0008
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4662174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian