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General NPI Number Information
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NPI Number | 1578351425
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Entity Type | Individual
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Provider Name | RACHEL LYN BLACKWOOD-PEREZ
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Gender | Female
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 2405 FRONT ST NE STE 230
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City | SALEM
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State | OR
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Zip | 97301-0860
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Country | US
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Telephone | 541-270-1952
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Fax |
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Provider Business Mailing Address
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Address Line | 810 JEV CT NW
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City | SALEM
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State | OR
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Zip | 97304-2652
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Country | US
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Telephone | 541-270-1952
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | A13531
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License Number State | OR
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