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BRYAN BLALOCK
NPI 1790138188
Counselor - Mental Health in Clackamas, OR

Active since July 20, 2016PECOS Enrolled
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015(503) 571-0884 Get Directions Write a Review

NPPES record last updated: November 6, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 6, 2025, Mar 21, 2025, Dec 28, 2021 (3 updates tracked since 2021).

About Bryan Blalock NPPES

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

BRYAN BLALOCK (NPI 1790138188) is an individual mental health provider in Clackamas, Oregon and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1790138188
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameBRYAN BLALOCK
Location Address10180 SE SUNNYSIDE RDClackamas, OR 97015-8970
Mailing Address12607 Se Mill Plain BlvdVancouver, WA 98684-6055 · (503) 249-3434
Phone(503) 571-0884
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJuly 20, 2016
Last NPPES UpdateNovember 6, 20253 updates tracked since enumeration
NPPES CertifiedNovember 6, 2025
✔ NPI 1790138188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
10180 SE SUNNYSIDE RD, Clackamas, OR 97015
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Kaiser Permanente.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bryan Blalock is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9931604782
PECOS Enrollment IDI20250924001849
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Bryan Blalock reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of The Northwest
0.3 mi
Sleep Disorder Diagnostic
9717 SE SUNNYSIDE RD, 3RD FLOOR
Clackamas, OR 97015
  • Reassigned Medicare billing, Oregon and Washington enrollments
  • Also billed through NPI 1871848457 (Washington)
  • 3,207 clinicians in this Medicare group
NPI 1174851505 (503) 659-2454

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DANIEL FORREST LOTSPEICH MD
Internal Medicine
10180 SE SUNNYSIDE RD, KAISER PERMANENTE DEPARTMENT OF INTERNAL MEDICINE
CLACKAMAS, OR 97015
Clackamas County (503) 652-2880
MEGAN LEA KELLY
Emergency Medicine
10180 SE SUNNYSIDE RD, KAISER SUNNYSIDE MEDICAL CENTER
CLACKAMAS, OR 97015
Clackamas County (503) 652-2880
JARROD L LARSON M.D.
Anesthesiology
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (800) 813-2000
JESSICA DAWN SEXTON-DORSETT
Nurse Anesthetist, Certified Registered
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (503) 813-2000
MR. DANE JAMES SLAGLE CRNA
Nurse Anesthetist, Certified Registered
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (503) 571-4506
RACHAEL SCOONES
Nurse Anesthetist, Certified Registered
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (800) 813-2000
ERIK WILLIAM FOSS MD
Radiology (Diagnostic Radiology)
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (503) 813-2000
DR. CARA LEE ROZELL D.O.
Psychiatry & Neurology (Neurology)
10180 SE SUNNYSIDE RD, DEPT OF NEUROLOGY, CLINIC C
CLACKAMAS, OR 97015
Clackamas County (503) 571-7200

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 Bryan Blalock's NPI number?

The NPI number for Bryan Blalock is 1790138188. It was assigned to this individual provider in the NPPES registry on July 20, 2016.

Where is Bryan Blalock located?

Bryan Blalock practices at 10180 SE Sunnyside Rd, Clackamas, OR 97015. The listed phone number is (503) 571-0884.

What is Bryan Blalock's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Bryan Blalock enrolled in Medicare?

Yes. Bryan Blalock is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Bryan Blalock's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bryan Blalock reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Northwest (Clackamas, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bryan Blalock's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Bryan Blalock accept?

Health plans from Kaiser Permanente list Bryan Blalock 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 Bryan Blalock was last updated on November 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.