MR. Jack Logan Keith JR., PMHNP
NPI #1982968210 in University Place, Washington
Provider Information
- NPI Number
- 1982968210
- Entity Type
- Individual
- Name
- MR. Jack Logan Keith JR., PMHNP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Credential
- PMHNP
- Enumeration Date
- Jul 2, 2012
- Last Updated
- Dec 3, 2025
Practice Location
- Address
- 6102 84TH AVENUE CT W
- City
- University Place
- State
- Washington
- ZIP Code
- 98467-4042
- Phone
- (360) 870-5411
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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