Individual ProviderKeira WyattCounselorBehavioral Health & Social Service ProvidersPractice Address711 State Ave NE, Olympia, WA 98506-3984(360) 943-0780PECOS EnrollmentBased on the most recent information from CMS, provider Keira Wyatt does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1932890753Provider TypeIndividualFull NameWyatt, KeiraGenderFemaleSole ProprietorNoEnumeration Date5/15/2023Last Updated5/15/2023Contact InformationPractice LocationPractice Address711 State Ave NE, Olympia, WA 98506-3984Phone(360) 943-0780FaxUnlisted FaxMailing LocationMailing Address711 State Ave NE, Olympia, WA 98506-3984Phone(360) 943-0780FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseCG61446272Washington