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BRYANNA MARIE JELLUM SUDP
NPI 1760955272
Counselor - Addiction (Substance Use Disorder) in Kelso, WA

Active since January 07, 2019
404 W MAIN ST, KELSO, WA 98626(360) 423-2806(360) 423-5128 Get Directions Write a Review

NPPES record last updated: April 21, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 21, 2021, Jan 7, 2019 (2 updates tracked since 2019).

About Bryanna Marie Jellum Sudp NPPES

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

BRYANNA MARIE JELLUM SUDP (NPI 1760955272) is an individual addiction (substance use disorder) provider in Kelso, Washington, licensed in Washington (60279397) and active in the NPI registry since January 2019.

NPPES Registry Identity

NPI1760955272
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameBRYANNA MARIE JELLUMCredential: SUDP
Location Address404 W MAIN STKelso, WA 98626-1118
Mailing Address404 W Main StKelso, WA 98626-1118 · (360) 423-2806 · Fax (360) 423-5128
Phone(360) 423-2806
Fax(360) 423-5128
Sole ProprietorNo
Enumeration DateJanuary 7, 2019
Last NPPES UpdateApril 21, 20212 updates tracked since enumeration
NPPES CertifiedApril 21, 2021
✔ NPI 1760955272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WA · 60279397
404 W MAIN ST, Kelso, WA 98626
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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.

MELODY KAY LORENZO
Psychologist (Addiction (Substance Use Disorder))
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
APRIL MARIE BASZLER
Counselor (Mental Health)
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
BRITTANY LYNN BIRTCHET CDPT
Counselor (Addiction (Substance Use Disorder))
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
STACY RAEANN WIRKKALA SUDPT
Counselor (Addiction (Substance Use Disorder))
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
AWAKENINGS, INC
Counselor (Addiction (Substance Use Disorder))
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
CORTNEY ANN BAKER CPC
Peer Specialist
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
MEGHAN DEGALLIER MSW, MHP, LICSWA
Counselor (Mental Health)
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806
BREANNA SLAPE-LORENZO
Counselor (Addiction (Substance Use Disorder))
404 W MAIN ST
KELSO, WA 98626
Cowlitz County (360) 423-2806

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bryanna Jellum's NPI number?

The NPI number for Bryanna Jellum is 1760955272. It was assigned to this individual provider in the NPPES registry on January 7, 2019.

Where is Bryanna Jellum located?

Bryanna Jellum practices at 404 W Main St, Kelso, WA 98626. The listed phone number is (360) 423-2806.

What is Bryanna Jellum's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Bryanna Jellum was last updated on April 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.