Individual provider Active NPI

Kailee Nuttall

  • Marriage & Family Therapist
  • University Place, WA
National Provider Identifier
1194386631
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
61425529 Issued in WA
Practice address
3560 Bridgeport Way W Ste 2C
University Place, WA 98466-4446
Phone
(253) 460-7248
NPI assigned
Jun 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 61425529 WA Primary

Addresses

Primary practice location

3560 Bridgeport Way W Ste 2C
University Place, WA 98466-4446

Mailing address

3560 Bridgeport Way W Ste 2C
University Place, WA 98466-4446
Phone (253) 460-7248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61425529WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tacoma Integrative Psychiatry PLLC PastSince Oct 22, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1194386631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 BRIDGEPORT WAY W STE 2C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664446",
            "telephone_number": "253-460-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 BRIDGEPORT WAY W STE 2C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664446",
            "telephone_number": "253-460-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTALL",
        "first_name": "KAILEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "61425529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.