Organization
MINDFUL MENTAL HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK LOGAN KEITH JR. ARNP, PMHNP-BC (OWNER)
(360) 870-5411
Entity
Organization
Contact information
Practice address
6102 84TH AVENUE CT W, UNIVERSITY PLACE, WA 98467-4042
(360) 870-5411
Mailing address
6102 84TH AVENUE CT W, UNIVERSITY PLACE, WA 98467-4042
(360) 870-5411
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/06/2025
Last updated
09/06/2025
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