NPIMap

Organization Active NPI

Gryphon Ketamine and Integratvie Therapies, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Issaquah, WA
National Provider Identifier
1851012298
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GRYPHON KETAMINE AND INTEGRATVIE THERAPIES, PLLC
Practice address
22525 SE 64TH PL # H-140
Issaquah, WA 98027-5383
Phone
(206) 245-7552
NPI assigned
Sep 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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

Authorized official

Name
Mr. Mitchell Keszler, CRNA, ARNPNPI 1578878153
Title
Co-Founder / Anesthesia Director
Phone
(206) 245-7552

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Infusion Therapy Clinic/Center 261QI0500X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

22525 SE 64TH PL # H-140
Issaquah, WA 98027-5383

Mailing address

22525 SE 64TH PL # H-140
Issaquah, WA 98027-5383
Phone (206) 245-7552

Other names 1

  • NA Former legal business name

National Provider Directory

National Provider Directory

Locations

22525 SE 64th Pl
#H140
Issaquah, WA 98027
Phone (206) 245-7552

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662336000000",
    "number": "1851012298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22525 SE 64TH PL # H-140",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275383",
            "telephone_number": "206-245-7552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22525 SE 64TH PL # H-140",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275383",
            "telephone_number": "206-245-7552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRYPHON KETAMINE AND INTEGRATVIE THERAPIES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A",
        "authorized_official_last_name": "KESZLER",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "CO-FOUNDER / ANESTHESIA DIRECTOR",
        "authorized_official_telephone_number": "206-245-7552",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA, ARNP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.