Individual
KORIE KERBER BLACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
818 COMMERCIAL ST STE 311, ASTORIA, OR 97103-4552
(503) 489-8821
Mailing address
818 COMMERCIAL ST STE 311, ASTORIA, OR 97103-4552
(503) 489-8821
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
R6435
OR
Other
Enumeration date
02/28/2021
Last updated
02/28/2021
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