MEDICARE: ALICIA LYNNE KEELER CNA, PEER SPECIALIST

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	376K00000X	Nurse's Aide	NC60680389	WA
2	175T00000X	Peer Specialist		WA

General Provider Information

NPI Number	:	1932735602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA LYNNE KEELER CNA, PEER SPECIALIST

Provider Business Mailing Address
First Line	:	950 BROADWAY STE 402
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98402-4454
Country	:	US
Telephone Number	:	253-235-9130
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 BROADWAY STE 402
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98402-4454
Country	:	US
Telephone Number	:	253-235-9130
Fax Number	:

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

Provider Enumeration Date	:	03/13/2020
Last Update Date	:	03/08/2026

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