Most Relevant Information
Provider Data
| NPI Number: | 1003519372 |
| Provider Name: | KEENAN SMITH PMHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 53-82167-102 |
Most Important Dates
| Enumeration Date: | 03/24/2023 |
| Last Updated: | 07/13/2023 |
Provider Practice Location
2105 112TH AVE NE STE 201
BELLEVUE
WA
980042945
Practice Location Phone/Fax
| Phone: | 4259685948 |
| Fax: |
Provider Mailing Location
PO BOX 1097
BIRMINGHAM
MI
480121097
Provider Mailing Phone/Fax
| Phone: | 2488389586 |
| Fax: |