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Mark Blaylock
Peer Specialist in Hillsboro, Oregon
NPI 1013511633

Mark Blaylock is a Peer Specialist based in Portland, OR. Mark Blaylock practices in Hillsboro, OR. The NPI Number for Mark Blaylock is 1013511633 and holds a License No. THW000002084 (Oregon).

The current practice location address for Mark Blaylock is 1049 Sw Baseline St Ste D480, Hillsboro, OR and can be reached out via phone at 503-465-2749.

Location: 1049 Sw Baseline St Ste D480, Hillsboro, OR, 97292-0576
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013511633
Provider Name
Mark Blaylock
Credential
Provider Entity Type
Individual
Gender
Male
Address
1049 Sw Baseline St Ste D480, Hillsboro, OR, 97292-0576
Phone Number
503-465-2749
Fax Number
Provider Enumeration Date
11/24/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1049 Sw Baseline St Ste D480
City
Hillsboro
State
Oregon
Zip
97123-3863
Phone Number
503-465-2749
Fax Number
person
Provider Business Mailing Address Details
Address
1049 Sw Baseline St Ste D480
City
Hillsboro
State
Oregon
Zip
97123-3863
Phone Number
503-465-2749
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
THW000002084 ()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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