Jelena Blackburn

Primary specialty

NaturopathTaxonomy code 175F00000X

License

2021 Issued in OR

Practice address

1000 Willagillespie Ste.175
Eugene, OR 97401-6003

Phone

(541) 238-2108

NPI assigned

Apr 21, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Elena Blackburn Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Avantgarde Aesthetic and Wellness Medical Center

  • Naturopath
  • Eugene, OR
  • NPI 1518526508
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1124448873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WILLAGILLESPIE RD STE 175",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017106",
            "telephone_number": "541-238-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WILLAGILLESPIE STE.175",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016003",
            "telephone_number": "541-238-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "JELENA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "2021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "BLACKBURN",
            "prefix": "DR.",
            "credential": "N.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Laurie Carol Black, Q.M.H.A
• Leeandra Raylene Black, MA, QMHP
• Stefanie Black
• Tim Black
• Blackbird Psychotherapy, LLC
• Roy M Blackburn, MD
• Michael Gene Blackmore, LMT
• Kyndra Blacks, LMT
• Carrie Blackwell, LMT
• Karen Renee Blackwell, LCSW

• Naturopath in Eugene, OR
• Providers in Eugene, OR by specialty
• Naturopath in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.