Individual
KAESRI KEOPANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
3639 MARTIN LUTHER KING JR WAY S, SEATTLE, WA 98144-6847
(206) 695-7506
(206) 695-7606
Mailing address
3639 MARTIN LUTHER KING JR WAY S, SEATTLE, WA 98144-6847
(206) 695-7506
(206) 695-7606
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00006116
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261QR0405X
—
WA
Enumeration date
02/04/2014
Last updated
02/20/2014
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