Individual provider · Type 1 NPI

Johnna Layne Keck, SUDP CP- 61191773

Addiction (Substance Use Disorder) Counselor · Ridgefield, WA

NPI number 1497207252 Active

Practice location

21810 NE 37th Ave
Ridgefield, WA 98642-7747

Fax (360) 397-7477

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X61191773 (WA)
Addiction (Substance Use Disorder) Counselor 101YA0400XCO60660639 (WA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1497207252

Johnna Layne Keck, SUDP CP- 61191773's National Provider Identifier is 1497207252, issued on Oct 27, 2016. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Ridgefield, WA. The record was last updated on Aug 3, 2026.