Individual
AIDAN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
201 160TH ST S STE 101, SPANAWAY, WA 98387-8508
(253) 904-6038
Mailing address
622 S 320TH ST STE A, FEDERAL WAY, WA 98003-4895
(360) 306-0682
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHCA.MC.70132956
WA
101YP2500X
Professional Counselor
MHCA.MC.70132956
WA
Other
Enumeration date
06/02/2026
Last updated
06/02/2026
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