Kloe Jasmine Burrell
Individual provider Active NPI Peer Specialist · Olympia, WA
NPI 1861180366 · NPPES record last updated Aug 17, 2023
Key facts
- NPI
- 1861180366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 1202 Black Lake Blvd SW
Suite B
Olympia, WA 98502-7208 - Phone
- (360) 878-8248
- NPI assigned
- Apr 24, 2023
- Reactivated
- Aug 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Community Services WW | Current |
Accepting new patients | |
| Catholic Community Services of Western Washington | Past | Accepting new patients |
Locations
1202 Black Lake Blvd SW
Ste B
Olympia, WA 98502
Phone (360) 968-3138
402 Yauger Way SW
Olympia, WA 98502
Phone (360) 968-0755
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes | ||
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
1202 Black Lake Blvd SW
Suite B
Olympia, WA 98502-7208
Mailing address
32216 Benbow Dr E
Graham, WA 98338-9083
Phone (253) 304-1214
Other providers in Olympia, WA
- Susan Lynette Burgess
- Blair Michael Burggren
- Melynda Burleson
- Marguerite Burnett
- Kathryn Mary Burrell
- Caitlin Ann Burrows
- Florence Marie-Louise Burrows
- Jessica Jordan Bursey
- Christopher P Burtner
- Melissa G Burtner
All providers in Olympia, WA · Peer Specialist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.