GERALD BLACKBURN

ISSAQUAH, WA
NPI1033661376
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: WA  CP00003663)
Enumeration Date2016-11-03
Last Update Date2016-11-03
Business Address
GERALD BLACKBURN
414 FRONT ST N
ISSAQUAH, WA 98027-2914
Phone number: 425-392-6367
Mailing Address
GERALD BLACKBURN
414 FRONT ST N
ISSAQUAH, WA 98027-2914
Phone number: 425-392-6367
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