Active NPI
Jeffrey Allen Kiilsgaard, LCSW, LICSW, ACSW
- Social Worker
- Seattle, WA
National Provider Identifier
1881074904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 10839
- Practice address
- 1455 NW Leary Way Ste 400
Seattle, WA 98107-5138 - Phone
- (253) 370-8980
- Fax
- (503) 966-0849
- NPI assigned
- Jun 3, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 10839 | OR | Primary |
Addresses
Primary practice location
1455 NW Leary Way Ste 400
Seattle, WA 98107-5138
Mailing address
10260 SW Greenburg Rd FL 4
Portland, OR 97223-5500
Phone (253) 368-3255
Other practice location 1
4800 S MacAdam Ave Ste 110
Portland, OR 97239-3929
Phone (253) 368-3255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10839 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Humanistic Therapy NW | Counselor | Current | Accepting new patients |
Locations
4800 S Macadam Ave
Ste 110
Portland, OR 97239
Phone (253) 368-3255
1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1881074904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10260 SW GREENBURG RD FL 4",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972235500",
"telephone_number": "253-368-3255",
"fax_number": "503-966-0849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1455 NW LEARY WAY STE 400",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981075138",
"telephone_number": "253-370-8980",
"fax_number": "503-966-0849"
}
],
"practiceLocations": [
{
"address_1": "4800 S MacAdam Ave Ste 110",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972393929",
"country_code": "US",
"telephone_number": "253-368-3255",
"fax_number": "503-966-0849",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIILSGAARD",
"first_name": "JEFFREY",
"middle_name": "ALLEN",
"credential": "LCSW, LICSW, ACSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-03",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OR",
"license": "10839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.