Individual
MRS. SHERYL ALICE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
24920 104TH AVE SE, KENT, WA 98030-6443
(425) 690-7592
(425) 690-9414
Mailing address
3600 LIND AVE SW, SUITE 100 ATTN CREDENTIALING, RENTON, WA 98057-4970
(425) 690-2715
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW60634799
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2068863
—
WA
Enumeration date
09/29/2016
Last updated
08/17/2021
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