KELLI JEAN ANDERSON (NPI# 1013403245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013403245 |
| Entity Type | Individual |
| Full Name | KELLI JEAN ANDERSON |
| Practice Address |
608 Ne 122nd Ave Vancouver WA 98684-5826 |
| Practice Telephone | 3606090560 |
| Mailing Telephone | 3606090560 |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2019-01-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| Y | 175T00000X | Peer Specialist | WA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700239738 | Kelli Ann Anderson | Registered Nurse | 16367 5 Mile Hwy, Onaway, MI 49765-9389 | 2016-07-14 |
| 1649610395 | Kelli Saage Anderson | Nurse Practitioner | 1146 Ross Clark Cir, Dothan, AL 36301-3022 | 2013-06-26 |
| 1548739717 | Kelli Anderson | Counselor | 1777 Axtell Dr Ste 100, Troy, MI 48084-4400 | 2018-11-17 |
| 1033643036 | Kelli Anderson | Case Manager/Care Coordinator | 3020 18th St Ste 3, Columbus, NE 68601-4254 | 2017-04-17 |
| 1891069928 | Kelli Anderson | Counselor | 120 Maple St, Springfield, MA 01103-2203 | 2012-03-07 |
| 1841574027 | Kelli Anderson | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2640 | 2011-10-05 |
| 1508167578 | Kelli Anderson | Case Management | 619 N Main St, Muskogee, OK 74401-4431 | 2010-11-08 |
| 1740424647 | Kelli Anderson | Nurse Practitioner | 4840 E Indian School Rd, Phoenix, AZ 85018-5500 | 2009-04-23 |
| 1760682439 | Kelli Anderson | Counselor | 205 S Adair St, Pryor, OK 74361-5201 | 2007-07-20 |
| 1992857775 | Kelli Christina Anderson | Specialist | 99 Kinderkamack Rd, Suite 112, Westwood, NJ 07675-3012 | 2007-01-18 |
| Street Address |
608 NE 122ND AVE |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98684-5826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285291849 | Pacifica Sylvan Park LLC | Alzheimer Center (Dementia Center) | 2400 Ne 112th Avenue, Vancouver, WA 98684 | 2019-05-20 |
| 1699242826 | Heidi Ericka Jackson | Registered Nurse | 15606 Ne 12th Way, Vancouver, WA 98684 | 2018-10-25 |
| 1477076727 | Brian Benasa Bardeloza | Dentist | 605 Se 164th Ave Ste 103, Vancouver, WA 98684 | 2017-07-19 |
| 1992226062 | Judith Moreno-castro | Massage Therapist | 2501 Ne 138th Ave., #60, Vancouver, WA 98684 | 2017-06-29 |
| 1346790706 | Samuel Joonsang Lee | Registered Nurse | 501 Se 172nd Ave Ste 210, Vancouver, WA 98684 | 2016-10-10 |
| 1912353178 | Cheryl A. Hamilton-jefferson | Counselor | 11818 Se Mill Plain Blvd Ste 311g, Vancouver, WA 98684 | 2016-05-06 |
| 1063866424 | Kim Forgione | Optometrist | 1900 Ne 162nd Ave Ste D103, Vancouver, WA 98684 | 2016-04-21 |
| 1700254257 | Desiree Haggart | Registered Nurse | 406 Se 131st St., Suite A101, Vancouver, WA 98684 | 2015-09-14 |
| 1215318068 | Paige M. King | Behavioral Analyst | 11818 Se Mill Plain Blvd Ste 203, Vancouver, WA 98684 | 2015-06-17 |
| 1417354366 | Amanda Hilkey, Lmp | Massage Therapist | 108 Se 24th Ave, Ste 9, Vancouver, WA 98684 | 2014-11-20 |
| Find all providers in zip 98684 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720554256 | Kay Marie Roberson | Peer Specialist | 1601 E Fourth Plain Blvd Ste A-152, Vancouver, WA 98661-3713 | 2018-10-23 |
| 1497241657 | Chelsey Nicole Parker | Peer Specialist | 9815 Ne 3rd St, Vancouver, WA 98664 | 2018-07-10 |
| 1043713449 | Claudia Gutierrez | Peer Specialist | 4601 E 18th St, Vancouver, WA 98661-6270 | 2018-03-12 |
| 1679082598 | Christopher Lewis Schwab | Peer Specialist | 5197 Nw Lower River Rd, Vancouver, WA 98660 | 2017-09-22 |
| 1225547151 | Dionne Marie Clark | Peer Specialist | 9105 Ne Highway 99 Ste 201a, Vancouver, WA 98665-8974 | 2017-09-22 |
| 1265974620 | Amanda Ewing | Peer Specialist | 16417 Ne 73rd St, Vancouver, WA 98682-1918 | 2016-11-15 |
| 1104438282 | Aydree Lee Stuart | Peer Specialist | 1601 E Fourth Plain Blvd, Vancouver, WA 98661-3713 | 2020-08-19 |
| 1548887870 | Oscar Daniel Beltran Leyva | Peer Specialist | 9300 Ne Oak View Dr, Vancouver, WA 98662-6157 | 2020-07-02 |
| 1336760917 | Lindsey Sinks | Peer Specialist | 9300 Ne Oak View Dr, Vancouver, WA 98662-6157 | 2020-05-05 |
| 1295356236 | Susan Mordick | Peer Specialist | 6926 Ne Fourth Plain Blvd, Vancouver, WA 98661-7254 | 2020-04-30 |
| Find all providers in VANCOUVER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.