DR. KELLY BLAKE EBRAHIMI DO
NPI 1700412319
Psychiatry & Neurology - Psychiatry in Tacoma, WA

Q: What is Kelly Ebrahimi's NPI number?

The NPI number for Kelly Ebrahimi is 1700412319. It was assigned to this individual provider in the NPPES registry on March 14, 2020. The provider is also known as Dr. Kelly Blake Do.

Q: What is Kelly Ebrahimi's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Ebrahimi was last updated on August 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 14, 2020

9040 JACKSON AVE, TACOMA, WA 98431(253) 968-2252 Get Directions Write a Review

NPPES record last updated: August 14, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 14, 2024, Jul 1, 2024, Jun 3, 2024 and 1 more (4 updates tracked since 2020).

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About Dr. Kelly Blake Ebrahimi Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY BLAKE EBRAHIMI DO (NPI 1700412319) is an individual psychiatry provider in Tacoma, Washington, licensed in Washington (OP61575651) and active in the NPI registry since March 2020.

NPPES Registry Identity

NPI1700412319

Entity TypeIndividualFemale

Primary Taxonomy2084P0800X

Provider Legal NameDR. KELLY BLAKE EBRAHIMICredential: DO

Location Address9040 JACKSON AVETacoma, WA 98431-5001

Mailing Address1 Jarrett White RdTripler Army Medical Center, HI 96859-5001

Phone(253) 968-2252

Sole ProprietorNo

Enumeration DateMarch 14, 2020

Last NPPES UpdateAugust 14, 20244 updates tracked since enumeration

NPPES CertifiedAugust 14, 2024

✔ NPI 1700412319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Licenses✔ Licensed in WA · OP61575651✔ Licensed in HI · DOS-2292

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedGeneral PracticeTaxonomy 208D00000X · License DOS-2292 (HI)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

9040 JACKSON AVE, Tacoma, WA 98431

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Other Names 1

Former Name (1)Dr. Kelly Blake Do

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL JOHN MEANS CRNA

Nurse Anesthetist, Certified Registered