Individual
AMORY E.W. BALLANTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 491-9480
(360) 456-2413
Mailing address
413 LILLY RD NE, OLYMPIA, WA 98506-5166
(360) 491-9480
(360) 456-2413
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW61652720
WA
Other
Enumeration date
06/16/2022
Last updated
05/28/2025
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