Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blake Anthony Davidson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1295678316

Blake Anthony Davidson is a Student in an Organized Health Care Education/Training Program in Portland, Oregon. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
2
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Practice location Address checks out

1839 NE Glisan St
Portland, OR 97232-2844
Phone: (503) 963-7676
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1295678316
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 13, 2026
Last updated in NPPESApril 13, 2026
Certification dateApril 13, 2026
Mailing addressPo Box 8459, Portland, OR 97207-8459

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