Individual
LESLIE L BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, CDP
Contact information
Practice address
1603 E ILLINOIS ST, BELLINGHAM, WA 98226-3644
(360) 647-4266
(360) 647-6057
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0112
(206) 764-0489
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1991660
—
WA
Enumeration date
01/27/2007
Last updated
07/08/2007
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