Provider Demographics
NPI:1750933958
Name:ADAMS, BLAKE (LMFT)
Entity type:Individual
Prefix:
First Name:BLAKE
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 FAIRVIEW AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3216
Mailing Address - Country:US
Mailing Address - Phone:206-681-6083
Mailing Address - Fax:
Practice Address - Street 1:2060 E CRESCENT DR
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-3434
Practice Address - Country:US
Practice Address - Phone:206-920-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-09
Last Update Date:2024-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61549891106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist