Kelly Sue Bracken, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP70050596 Issued in WA

Practice address

400 E Evergreen Blvd Ste 217
Vancouver, WA 98660-3264

Phone

(509) 596-1138

Fax

(971) 308-7811

NPI assigned

Oct 1, 2025

Last updated

Oct 1, 2025By the provider in NPPES

Sex

Female

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

Practice roles

Locations

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

• Livewell

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1922820489
  NPD

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1861366932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E EVERGREEN BLVD STE 217",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603264",
            "telephone_number": "509-596-1138",
            "fax_number": "971-308-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E EVERGREEN BLVD STE 217",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603264",
            "telephone_number": "509-596-1138",
            "fax_number": "971-308-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "KELLY SUE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP70050596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittani Nicole Bozeman, MA
• BR Anesthesia-Wa PLLC
• Katherine Braaten, LMT
• Ariana Brace
• Kelly Brachman, MSW
• Kristy Bracken, LMP
• Rachael M Bradbury, BA, AAC
• Chloe Bradley
• Helen L Bradley
• Jill Renee Bradley, FNP

• Psychiatric/Mental Health Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.