Mary Knoblock

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Practice address

22804 W Bluff Dr
West Linn, OR 97068-8261

Phone

(503) 807-4122

NPI assigned

Apr 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Haven Wellness Company

  • Clinic/Center
  • West Linn, OR
  • NPI 1811701675
  NPD Authorized official

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1922637701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22804 W BLUFF DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970688261",
            "telephone_number": "503-807-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22804 W BLUFF DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970688261",
            "telephone_number": "503-807-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOBLOCK",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Kim
• Richard Barrett King, ED.D.
• Amy Kingsbury, LCSW
• Walker Jamey Kirkpatrick, N.D.
• Shannen Knight
• Lauren Kay Knutson
• Lauren Elizabeth Koch, D.P.T.
• Megan Koehler
• Jody M Koppang, LPC
• Abby S Krause

• Health & Wellness Coach in West Linn, OR
• Providers in West Linn, OR by specialty
• Health & Wellness Coach in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.