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NPI Code Detail

MEDICARE: KEENAN MICHAEL GRIEGO NP

MEDICARE: KEENAN MICHAEL GRIEGO NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse PractitionerAPN.0998159-NPCO
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPN.0998159-NPCO

General Provider Information

NPI Number : 1346858404
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEENAN MICHAEL GRIEGO NP
Provider Business Mailing Address
First Line : PO BOX 5127
Second Line :
City : EVERETT
State : WA
Zip : 98206-5127
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5410 POWERS CENTER PT STE 230
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-7148
Country : US
Telephone Number : 719-282-6100
Fax Number : 719-282-6106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2020
Last Update Date : 12/29/2025

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