Healthcare Provider Details

I. General information

NPI: 1104450048
Provider Name (Legal Business Name): KEELY C ROBINSON CNM, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24920 104TH AVE SE
KENT WA
98030-6443
US

IV. Provider business mailing address

955 POWELL AVE SW
RENTON WA
98057-2908
US

V. Phone/Fax

Practice location:
  • Phone: 253-876-3939
  • Fax: 253-876-3940
Mailing address:
  • Phone: 425-277-1311
  • Fax: 425-277-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60806457
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP61163262
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: