Individual
CAREY BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 WEST MAPLE STREET, MEDICAL LAKE, WA 99022-0800
(509) 299-3121
(509) 299-7015
Mailing address
800 WEST MAPLE STREET, MEDICAL LAKE, WA 99022-0800
(509) 299-3121
(509) 299-7015
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00004150
WA
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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