Individual
AMANDA JEANNINE BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3107 S DEARBORN ST, SEATTLE, WA 98144-3228
(360) 223-2073
Mailing address
3107 S DEARBORN ST, SEATTLE, WA 98144-3228
(360) 223-2073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
60969266
WA
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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