Individual
CASEY BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1711 MAIN ST, VANCOUVER, WA 98660
(360) 200-4481
Mailing address
4501 NW OLIVE ST, VANCOUVER, WA 98663-1773
(917) 952-0762
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/02/2016
Last updated
08/23/2018
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