Healthcare Provider Details
I. General information
NPI: 1295410322
Provider Name (Legal Business Name): CITADEL PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2023
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2615 JAHN AVE NW STE E4
GIG HARBOR WA
98335-7997
US
IV. Provider business mailing address
5606 18TH ST NW
GIG HARBOR WA
98335-7527
US
V. Phone/Fax
- Phone: 360-334-7197
- Fax:
- Phone: 360-334-7197
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMAL
WILLIAMS
Title or Position: CEO, FOUNDER
Credential: ARNP
Phone: 360-334-7197