Provider Demographics
NPI:1255952628
Name:DUKE, KERRI ANN
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:ANN
Last Name:DUKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6706 PRAIRIE RIDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-6248
Mailing Address - Country:US
Mailing Address - Phone:360-455-0202
Mailing Address - Fax:
Practice Address - Street 1:6706 PRAIRIE RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-6248
Practice Address - Country:US
Practice Address - Phone:360-455-0202
Practice Address - Fax:360-455-0202
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000075841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical