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1033661376
GERALD BLACKBURN
ISSAQUAH, WA
NPI
1033661376
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CP00003663)
Enumeration Date
2016-11-03
Last Update Date
2016-11-03
Business Address
-- GERALD BLACKBURN
414 FRONT ST N
ISSAQUAH, WA 98027-2914
Phone number: 425-392-6367
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Mailing Address
-- GERALD BLACKBURN
414 FRONT ST N
ISSAQUAH, WA 98027-2914
Phone number: 425-392-6367
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