Keith Madison Wilks, COUNSELOR

Primary specialty

CounselorTaxonomy code 101Y00000X

License

CG61094671 Issued in WA

Practice address

842 Gina CT SE
Olympia, WA 98513-7743

Phone

(360) 999-9080

NPI assigned

Nov 16, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1366217762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 GINA CT SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985137743",
            "telephone_number": "360-999-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 GINA CT SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985137743",
            "telephone_number": "360-999-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "KEITH",
        "middle_name": "MADISON",
        "credential": "COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG61094671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Robert Wilder, DMD
• Wildflower Telehealth Network Inc.
• Wildwood Speech Therapy LLC
• Elizabeth Ann Wiley, MD, JD, MPH
• Jana Lyn Wiley, L.AC.
• Ryan E Will, MD
• Nancy Willard, M.A. CCC/SLP
• Cassandra J Willbourn, RN
• William J McKeon LLC
• Candace William, S.W.

• Counselor in Olympia, WA
• Providers in Olympia, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.