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General NPI Number Information
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NPI Number | 1841089919
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Entity Type | Organization
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Legal Business Name | CEDAR & SAGE MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1801 W BAY DR NW STE 208B7
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City | OLYMPIA
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State | WA
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Zip | 98502-4310
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Country | US
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Telephone | 253-242-3560
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 W BAY DR NW STE 208B7
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City | OLYMPIA
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State | WA
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Zip | 98502-4310
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Country | US
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Telephone | 253-242-3560
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KEANNA SMITH
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Credential | PMHNP-BC, ARNP
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Telephone | 253-242-3560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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