Individual provider Active NPI

Blaine Lorrence, CSWA, CADC III

  • Addiction (Substance Use Disorder) Counselor
  • Redmond, OR
National Provider Identifier
1063143071
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1655 SW Highland Ave Ste 3
Redmond, OR 97756-2558
Phone
(541) 923-2654
NPI assigned
Jun 21, 2022
Last updated
Dec 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

1655 SW Highland Ave Ste 3
Redmond, OR 97756-2558

Mailing address

423 NW 6TH St Apt 8
Redmond, OR 97756-1685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1063143071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 NW 6TH ST APT 8",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 SW HIGHLAND AVE STE 3",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562558",
            "telephone_number": "541-923-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORRENCE",
        "first_name": "BLAINE",
        "credential": "CSWA, CADC III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-21",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.