RYAN RUSSELL BLACK

TACOMA, WA
NPI1396003414
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: NC  C008913)
Enumeration Date2012-04-26
Last Update Date2020-03-26
Business Address
RYAN RUSSELL BLACK LMSW, LCSW
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA 98431-4504
Phone number: 253-968-0982
Mailing Address
RYAN RUSSELL BLACK LMSW, LCSW
17903 CIELO CT
SAN ANTONIO, TX 78257-5016
Phone number: 602-628-0014