Kerra E Blakely, CADC, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3585 Issued in OR

Practice address

3710 SW US Veterans Hospital Rd
P3-PRRC
Portland, OR 97239-2964

Phone

(503) 220-8262

NPI assigned

Aug 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1366559692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1034",
            "address_2": "P3-PRRC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972071034",
            "telephone_number": "503-220-8262",
            "fax_number": "503-273-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "address_2": "P3-PRRC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964",
            "telephone_number": "503-220-8262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14600 NW Cornell Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972295442",
            "country_code": "US",
            "telephone_number": "503-645-3581",
            "fax_number": "503-629-8517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "KERRA",
        "middle_name": "E",
        "credential": "CADC, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle L Blake, RN
• Linda Cherise Blake, PHARMD, PHD
• Lindsey Blake
• Lisa D Blake, LMT
• Tyschal Lumbrea Blake
• Thomas Lawrence Blakely, CCC-SLP
• Cortney C Blakemore, CRNA
• Rachel Hope Blakemore, OD
• Patricia Evans Blakeslee, L.AC., R.N.
• David Blakey

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.