Individual provider · Type 1 NPI
Jack Logan Keith Jr., PMHNP
Psychiatric/Mental Health Nurse Practitioner · University Place, WA
NPI number
1982968210
Active · reactivated Feb 13, 2020
Practice location
6102 84th Avenue Ct W
University Place, WA 98467-4042
Fax (888) 414-8151
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 202110580NP-PP (OR) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | AP61193548 (WA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1982968210
Jack Logan Keith Jr., PMHNP's National Provider Identifier is 1982968210, issued on Jul 2, 2012. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in University Place, WA. The record was last updated on Dec 3, 2025.