Provider Demographics
NPI:1942199195
Name:KEITH, SOPHIA FRANCES
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:FRANCES
Last Name:KEITH
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 1:18640 132ND ST SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-7905
Mailing Address - Country:US
Mailing Address - Phone:360-280-4743
Mailing Address - Fax:
Practice Address - Street 1:18640 132ND ST SE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-7905
Practice Address - Country:US
Practice Address - Phone:360-280-4743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician