Provider Demographics
NPI:1841221165
Name:KEYES, JAMES A (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:KEYES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:KEYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:805 164TH ST SE STE 101
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6316
Mailing Address - Country:US
Mailing Address - Phone:425-385-3262
Mailing Address - Fax:425-357-0924
Practice Address - Street 1:15418 MAIN ST
Practice Address - Street 2:UNIT M301
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-9031
Practice Address - Country:US
Practice Address - Phone:425-385-3262
Practice Address - Fax:425-357-0924
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2009103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist