Individual
MR. KERRY D BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
929 SW 152ND ST, SUITE D, BURIEN, WA 98166-1843
(206) 431-3171
(206) 242-7330
Mailing address
929 SW 152ND ST, SUITE D, BURIEN, WA 98166-1843
(206) 431-3171
(206) 242-7330
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00005759
WA
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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