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Holly Blalack
Peer Specialist in Tigard, Oregon
NPI 1942778139

Holly Blalack is a Peer Specialist based in Tigard, OR. Holly Blalack practices in Tigard, OR. The NPI Number for Holly Blalack is 1942778139 and holds a License No. 18-CRM-045 (Oregon).

The current practice location address for Holly Blalack is 12540 Sw Main St Ste 202, Tigard, OR and can be reached out via phone at 503-906-9995. You can also correspond with Holly Blalack through the mailing address at 12540 SW MAIN ST STE 202, TIGARD, OR - 97223-6198 (mailing address contact number: 503-906-9995).

Location: 12540 Sw Main St Ste 202, Tigard, OR, 97223-6198
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1942778139
Provider Name
Holly Blalack
Credential
Provider Entity Type
Individual
Gender
Female
Address
12540 Sw Main St Ste 202, Tigard, OR, 97223-6198
Phone Number
503-906-9995
Fax Number
Provider Enumeration Date
11/06/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
12540 Sw Main St Ste 202
City
Tigard
State
Oregon
Zip
97223-6198
Phone Number
503-906-9995
Fax Number
person
Provider Business Mailing Address Details
Address
12540 Sw Main St Ste 202
City
Tigard
State
Oregon
Zip
97223-6198
Phone Number
503-906-9995
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
18-CRM-045 (Oregon)
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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