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1790138188
BRYAN BLALOCK
CLACKAMAS, OR
NPI
1790138188
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-07-20
Last Update Date
2021-12-28
Business Address
BRYAN BLALOCK
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 97015-8970
Phone number: 503-571-0884
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Mailing Address
BRYAN BLALOCK
1027 E BURNSIDE ST
PORTLAND, OR 97214-1328
Phone number: 503-239-8400
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