MEDICARE: CEDAR & SAGE MENTAL HEALTH PLLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1841089919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEDAR & SAGE MENTAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	1801 W BAY DR NW STE 208B
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4310
Country	:	US
Telephone Number	:	253-242-3560
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 W BAY DR NW STE 208B7
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4310
Country	:	US
Telephone Number	:	253-242-3560
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KEANNA SMITH
Credential	:	PMHNP-BC, ARNP
Telephone Number	:	253-242-3560

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	04/02/2026

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