Most Relevant Information
Provider Data
| NPI Number: | 1003205147 |
| Provider Name: | C HENRY BALDERRAMA MSW, LICSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | LW00005964 |
Most Important Dates
| Enumeration Date: | 01/13/2015 |
| Last Updated: | 09/10/2015 |
Provider Practice Location
1201 S PROCTOR ST
TACOMA
WA
984052047
Practice Location Phone/Fax
| Phone: | 2533965263 |
| Fax: |
Provider Mailing Location
1102 SW 348TH PL
FEDERAL WAY
WA
980237029
Provider Mailing Phone/Fax
| Phone: | 2065795382 |
| Fax: |