Healthcare Provider Details

I. General information

NPI: 1619713138
Provider Name (Legal Business Name): STEATH KEENER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 2ND AVE STE 200
SEATTLE WA
98101-1186
US

IV. Provider business mailing address

1140 NW MARKET ST UNIT 217
SEATTLE WA
98107-3878
US

V. Phone/Fax

Practice location:
  • Phone: 206-448-8500
  • Fax:
Mailing address:
  • Phone: 253-346-4339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: