Dr BLAYNE A STANDAGE is a male medical professional, specializing in General Surgery. He graduated in 1980.
LEGACY CLINICS LLC
1130 NW 22ND AVE
PORTLAND
OR
972102934
Tel:
| Npi | 1164410874 |
| Pac Id | 4385660901 |
| Professional Enrollment Id | I20090211000441 |
| Last Name | STANDAGE |
| First Name | BLAYNE |
| Middle Name | A |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 1980 |
| Primary Specialty | GENERAL SURGERY |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | LEGACY CLINICS LLC |
| Group Practice Pac Id | 0244144004 |
| Number Of Group Practice Members | 460 |
| Line 1 Street Address | 1130 NW 22ND AVE |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | Y |
| City | PORTLAND |
| State | OR |
| Zip Code | 972102934 |
| Phone Number | |
| Hospital Affiliation Ccn 1 | 380017 |
| Hospital Affiliation Lbn 1 | LEGACY GOOD SAMARITAN MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | |
| Hospital Affiliation Lbn 2 | |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
Leave your comments, questions and feedback on this listing below. You can also correct any listing errors or omissions.