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General NPI Number Information
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NPI Number | 1952577934
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Entity Type | Individual
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Provider Name | KELLY J NIESS LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 4601 GUEMES VW
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City | ANACORTES
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State | WA
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Zip | 98221-1118
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Country | US
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Telephone | 206-999-6771
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Fax |
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Provider Business Mailing Address
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Address Line | 325 E PIONEER AVE
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City | PUYALLUP
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State | WA
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Zip | 98372-3265
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Country | US
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Telephone | 253-697-8548
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Fax | 253-697-8590
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LF60123463
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License Number State | WA
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