Individual
KRISTINA RENEE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1520 KELLY PL, WALLA WALLA, WA 99362-8607
(509) 838-4651
Mailing address
PO BOX 959, YAKIMA, WA 98907-0959
(509) 524-2934
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X
WA
Other
Enumeration date
09/01/2022
Last updated
04/25/2025
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