Individual
MR. JUSTIN BLAKE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1660 S. COLUMBIAN WAY, MAILSTOP: (S-116), SEATTLE, WA 98108
(206) 764-2007
Mailing address
1660 S. COLUMBIAN WAY, MAILSTOP: (S-116), SEATTLE, WA 98108
(206) 764-2007
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
61139465
WA
Other
Enumeration date
08/24/2018
Last updated
08/05/2022
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