Basic Information
| Provider Information | |||||||||
| NPI: | 1124780952 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRISBY | ||||||||
| FirstName: | KALAB | ||||||||
| MiddleName: | BLAKE | ||||||||
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| Credential: | MPA, MSW, LSWAIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2230 CORNERSTONE LN UNIT 218 | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982266003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7192338916 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2203 OLD HIGHWAY 99 S RD | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982739009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605428810 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2021 | ||||||||
| LastUpdateDate: | 05/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | SC61234480 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.