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General NPI Number Information
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NPI Number | 1881074904
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Entity Type | Individual
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Provider Name | JEFFREY ALLEN KIILSGAARD LCSW, LICSW, ACSW
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Gender | Male
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Dates
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Enumeration Date | 06/03/2015
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 1455 NW LEARY WAY STE 400
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City | SEATTLE
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State | WA
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Zip | 98107-5138
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Country | US
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Telephone | 253-370-8980
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Fax | 503-966-0849
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Provider Business Mailing Address
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Address Line | 10260 SW GREENBURG RD FL 4
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City | PORTLAND
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State | OR
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Zip | 97223-5500
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Country | US
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Telephone | 253-368-3255
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Fax | 503-966-0849
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 10839
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License Number State | OR
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