Klean Physicians Group, LLC.

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

Legal business name

KLEAN PHYSICIANS GROUP, LLC.

Practice address

211 Pioneer Rd W
Long Beach, WA 98631-3654

Phone

(360) 642-3105

Fax

(360) 642-2766

NPI assigned

May 29, 2014

Organization subpart

No

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

Authorized official

Name

Andrew Spanswick

Title

Ceo

Phone

(310) 435-8096

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1376955930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W SUNSET BLVD",
            "address_2": "SUITE 650B",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900695801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 PIONEER RD W",
            "city": "LONG BEACH",
            "state": "WA",
            "postal_code": "986313654",
            "telephone_number": "360-642-3105",
            "fax_number": "360-642-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLEAN PHYSICIANS GROUP, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "SPANSWICK",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-435-8096"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Jolly
• Jason Kagie, BA OF PSYCHOLOGY
• Michelle Kemmer
• Destini Kirkwood, LMHCA, AAC
• Klean Long Beach, Wa, LLC
• Anna Marie Klingler
• Grant P Kolb
• Travis Krueger
• Jereen Laferriere
• Anna Lang, COUNSELOR

• Group Psychotherapy Psychologist in Long Beach, WA
• Providers in Long Beach, WA by specialty
• Group Psychotherapy Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.