Provider Demographics
NPI:1093601015
Name:KEYNA GRAHAM-HEINE, PLLC
Entity type:Organization
Organization Name:KEYNA GRAHAM-HEINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KEYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM-HEINE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, PMHNP
Authorized Official - Phone:253-364-6054
Mailing Address - Street 1:9116 GRAVELLY LAKE DR SW STE 107
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9116 GRAVELLY LAKE DR SW STE 107
Practice Address - Street 2:PMB 1385
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3148
Practice Address - Country:US
Practice Address - Phone:253-364-6054
Practice Address - Fax:253-218-6974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health