Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keystone Tides, PLLC

Organization Developmental Disabilities Clinic/Center · NPI 1306649884

Keystone Tides, PLLC is a Developmental Disabilities Clinic/Center in Port Angeles, Washington. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

115 E Railroad Ave Ste 203
Port Angeles, WA 98362-2925
Phone: (425) 400-8602
Fax: (425) 433-9177
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X
Developmental Disabilities Clinic/Center Taxonomy 261QD1600X
Adult Mental Health Clinic/Center Taxonomy 261QM0850X
Adolescent and Children Mental Health Clinic/Center Taxonomy 261QM0855X

Record details

NPI number1306649884
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jessica Johnson — Owner · (303) 775-0065
NPI enumeratedMarch 31, 2025
Last updated in NPPESMarch 31, 2025
Certification dateMarch 30, 2025
Mailing address132 Deer Park Rd # 21, Port Angeles, WA 98362-7185