Healthcare Provider Details

I. General information

NPI: 1609717982
Provider Name (Legal Business Name): ANNE BLATNER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 SW GRIFFITH DR STE 135
BEAVERTON OR
97005-2977
US

IV. Provider business mailing address

4900 SW GRIFFITH DR STE 135
BEAVERTON OR
97005-2977
US

V. Phone/Fax

Practice location:
  • Phone: 503-608-7717
  • Fax: 503-608-7718
Mailing address:
  • Phone: 503-608-7717
  • Fax: 503-608-7718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number900004110
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: