MS. MARTHA L BLAKE PSYCHOLOGIST, NCPSYT
NPI 1083632129
Psychologist in Tualatin, OR

Active since July 17, 2006Opted out of Medicare · through Apr 1, 2028
I-5 BETWEEN HWY 217 AND I-205, TUALATIN, OR 97062(503) 691-6391(503) 691-8451 Get Directions Write a Review

NPPES record last updated: December 16, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Martha L Blake Psychologist, Ncpsyt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. MARTHA L BLAKE PSYCHOLOGIST, NCPSYT (NPI 1083632129) is an individual psychologist in Tualatin, Oregon, licensed in Oregon (1824) and active in the NPI registry since July 2006. She has opted out of Medicare through April 1, 2028.

NPPES Registry Identity

NPI1083632129
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameMS. MARTHA L BLAKECredential: PSYCHOLOGIST, NCPSYT
Location AddressI-5 BETWEEN HWY 217 AND I-205Tualatin, OR 97062-9773
Mailing AddressI-5 Between Hwy 217 And I-205Tualatin, OR 97062-9773 · (503) 691-6391 · Fax (503) 691-8451
Fax(503) 691-8451
Sole ProprietorYes
Enumeration DateJuly 17, 2006
Last NPPES UpdateDecember 16, 2013
NPI 1083632129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in OR · 1824
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychoanalystTaxonomy 102L00000X · License 0003361 (NY)
I-5 BETWEEN HWY 217 AND I-205, Tualatin, OR 97062

Other Identifiers 1

Other0003361NY · License

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Ms. Martha L Blake Psychologist, Ncpsyt has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2016 through April 1, 2028.

Opt-Out Effective DateApril 1, 2016
Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Martha Blake's NPI number?

The NPI number for Martha Blake is 1083632129. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Where is Martha Blake located?

Martha Blake practices at I-5 Between Hwy 217 And I-205, Tualatin, OR 97062. The listed phone number is (503) 691-6391.

What is Martha Blake's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Martha Blake enrolled in Medicare?

No. Martha Blake has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Martha Blake accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Martha Blake as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Martha Blake was last updated on December 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.