NPI 1013511633

Mark Blaylock

Practitioner Peer Specialist Hillsboro, OR

Practice location

Address: 1049 SW Baseline St STE D480, Hillsboro, OR 97123-3863
Phone: (503) 465-2749
Mailing address: PO Box 16576, Portland, OR 97292-0576

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence THW000002084

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Registry record

NPI: 1013511633
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Nov 2020
Record last updated: 24 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.