Individual
KRISTINE D. BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W.
Contact information
Practice address
MADIGAN ARMY MEDICAL CTR 9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-4146
(253) 968-4249
Mailing address
MADIGAN ARMY MEDICAL CENTER, 9040 JACKSON AVENUE, TACOMA, WA 98371-1100
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00007353
WA
Other
Enumeration date
03/20/2007
Last updated
04/16/2019
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