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HOLLY BLALACK
NPI 1942778139
Peer Specialist in Tigard, OR

Active since November 06, 2018
12540 SW MAIN ST STE 202, TIGARD, OR 97223(503) 906-9995 Get Directions Write a Review

NPPES record last updated: November 6, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Holly Blalack NPPES

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

HOLLY BLALACK (NPI 1942778139) is an individual peer specialist in Tigard, Oregon, licensed in Oregon (18-CRM-045) and active in the NPI registry since November 2018.

NPPES Registry Identity

NPI1942778139
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameHOLLY BLALACK
Location Address12540 SW MAIN ST STE 202Tigard, OR 97223-6198
Mailing Address12540 Sw Main St Ste 202Tigard, OR 97223-6198 · (503) 906-9995
Phone(503) 906-9995
Sole ProprietorNo
Enumeration DateNovember 6, 2018
✔ NPI 1942778139 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in OR · 18-CRM-045
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.
12540 SW MAIN ST STE 202, Tigard, OR 97223
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Other Providers at the Same Location NPPES 16

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

ARYA ROERIG CADC 1
Counselor (Addiction (Substance Use Disorder))
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995
RECOVERY WORKS NW LLC
Clinic/Center (Multi-Specialty)
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995
SARA KJESETH CRM
Peer Specialist
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995
TAMMY YOUNG CRM/PSS
Peer Specialist
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (458) 262-8374
MRS. JENNIFER ROSE WITTEN NP
Nurse Practitioner (Adult Health)
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995
KENNETH ALLEN DOUGHERTY CRM, QMHA-I
Peer Specialist
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995
ALEX E MAHLIOS CADC
Counselor (Addiction (Substance Use Disorder))
12540 SW MAIN ST STE 202
PORTLAND, OR 97223
Washington County (503) 906-9995
FRANK CARTER HABECKER CADC-R
Counselor (Addiction (Substance Use Disorder))
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995

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 Holly Blalack's NPI number?

The NPI number for Holly Blalack is 1942778139. It was assigned to this individual provider in the NPPES registry on November 6, 2018.

Where is Holly Blalack located?

Holly Blalack practices at 12540 SW Main St Ste 202, Tigard, OR 97223. The listed phone number is (503) 906-9995.

What is Holly Blalack's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Holly Blalack was last updated on November 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.