BLAKE CARENTON MOSS

SAMMAMISH, WA
NPI1326837931
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CO61411437)
Enumeration Date2025-05-01
Last Update Date2025-05-01
Business Address
BLAKE CARENTON MOSS
4425 ISSAQUAH PINE LAKE RD SE APT I14
SAMMAMISH, WA 98075-6247
Phone number: 832-943-7204
Mailing Address
BLAKE CARENTON MOSS
33010 SE 99TH ST
SNOQUALMIE, WA 98065-9797
Phone number: 425-831-2500
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