Individual
DR. KELLY BLASKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-2252
(253) 968-3278
Mailing address
1615 N STEVENS ST, TACOMA, WA 98406-3827
(814) 360-2113
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60205227
WA
Other
Enumeration date
01/16/2017
Last updated
05/09/2019
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