Provider Demographics
NPI:1932656865
Name:BLESSINGTON, MARTHA (AC)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:
Last Name:BLESSINGTON
Suffix:
Gender:F
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 NW 20TH AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1452
Mailing Address - Country:US
Mailing Address - Phone:503-704-1958
Mailing Address - Fax:
Practice Address - Street 1:811 NW 20TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1452
Practice Address - Country:US
Practice Address - Phone:503-704-1958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC179322171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist