Provider Demographics
NPI:1619846813
Name:THOMAS, KISHA KENELE (BA)
Entity type:Individual
Prefix:
First Name:KISHA
Middle Name:KENELE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 CHERRY PLACE
Mailing Address - Street 2:SUITE #300
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310
Mailing Address - Country:US
Mailing Address - Phone:360-792-2020
Mailing Address - Fax:
Practice Address - Street 1:2500 CHERRY PLACE
Practice Address - Street 2:SUITE #300
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310
Practice Address - Country:US
Practice Address - Phone:360-792-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor