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

Jay L Blake, NP

Individual provider Nurse Practitioner · NPI 1619284742

Jay L Blake, NP is a Nurse Practitioner in Eugene, Oregon. Qualified in 2014, 12 years ago. Practices with Medderm Corporation, a 6-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
12
Licensed in
OR
In the registry since
2010
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

920 Country Club Rd Ste 140A
Eugene, OR 97401-6024
Phone: (971) 915-8585
Fax: (503) 362-8435
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1010 Sw Coast Hwy Ste 201, Newport, OR 97365-5240 — (866) 599-3376

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 10042189 (OR)

Record details

NPI number1619284742
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedSeptember 10, 2010
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026
Mailing address1793 13th St Se, Salem, OR 97302-2541

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Medderm Corporation — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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