Dr. KELLY BLAKE EBRAHIMI DO
Individual Provider (NPI-1)
Active
Psychiatry & Neurology, Psychiatry
Provider Information
- NPI Number
1700412319- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DO
- Status
- Active
Contact & Location
- Address
- 9040 JACKSON AVE, TACOMA, WA, 984315001
- Phone
- (253) 968-2252
Specialties & Taxonomies
Psychiatry & Neurology, Psychiatry
License: HI #DOS-2292
General Practice
License: HI #DOS-2292
Student in an Organized Health Care Education/Training Program
Psychiatry & Neurology, Psychiatry
Primary License: WA #OP61575651
All Addresses
MAILING
1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER, HI, 968595001