MEDICARE: MRS. LEAPHA ANNE KEYLON MSW, LCSW

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
1	101YM0800X	Mental Health Counselor	LW00005243	WA

General Provider Information

NPI Number	:	1578670790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEAPHA ANNE KEYLON MSW, LCSW

Provider Business Mailing Address
First Line	:	13623 272ND ST NE
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-6831
Country	:	US
Telephone Number	:	360-631-0243
Fax Number	:	360-435-6215

Provider Business Practice Location Address
First Line	:	307 N OLYMPIC AVE STE 213
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1351
Country	:	US
Telephone Number	:	360-631-0243
Fax Number	:	360-435-6215

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	07/08/2007

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