Individual
JONATHAN P KILIAN
Active
Individual
JONATHAN P KILIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LW60908637
WA
1041C0700X
Clinical Social Worker
Primary
LW60908637
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W720382802
REGENCE BLUE CROSS
WA
Enumeration date
10/02/2018
Last updated
10/25/2019
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