# HEATHER BLACKMORE MA LMFTA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306253067
- **Authorized official:** MS. HEATHER ANNE BLACKMORE MA LMFTA (OWNER)
- **Authorized official phone:** (360) 649-1238

## Contact information

- **Practice address:** 374 NE MAX WILLIAM LOOP, POULSBO, WA 98370
- **Practice address phone:** (360) 649-1238
- **Mailing address:** 374 NE MAX WILLIAM LOOP, POULSBO, WA 98370-9169
- **Mailing address phone:** (360) 649-1238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | MG60354376 | WA | Yes |

## Other

- **Enumeration date:** 07/15/2014
- **Last updated:** 07/15/2014