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NPI Code Detail

MEDICARE: JOHN BLANCHARD

MEDICARE: JOHN BLANCHARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2175T00000XPeer Specialist

General Provider Information

NPI Number : 1245608629
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN BLANCHARD
Provider Business Mailing Address
First Line : PO BOX 237
Second Line :
City : FALLS CITY
State : OR
Zip : 97344-0237
Country : US
Telephone Number : 503-787-4514
Fax Number :
Provider Business Practice Location Address
First Line : 182 SW ACADEMY ST STE 333
Second Line :
City : DALLAS
State : OR
Zip : 97338-1996
Country : US
Telephone Number : 503-623-9289
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2015
Last Update Date : 10/23/2024

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