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

Dr. Kelly Blake Ebrahimi, DO

Individual provider Psychiatry Physician · NPI 1700412319

Dr. Kelly Blake Ebrahimi, DO is a Psychiatry Physician in Tacoma, Washington. Licensed in Hawaii and Washington. Registered with an NPI since 2020.

Licensed in
HI, WA
In the registry since
2020
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

9040 Jackson Ave
Tacoma, WA 98431-5001
Phone: (253) 968-2252
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence OP61575651 (WA)
Psychiatry Physician Taxonomy 2084P0800X · Licence DOS-2292 (HI)
General Practice Physician Taxonomy 208D00000X · Licence DOS-2292 (HI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1700412319
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 14, 2020
Last updated in NPPESAugust 14, 2024
Certification dateAugust 14, 2024
Mailing address1 Jarrett White Rd, Tripler Army Medical Center, HI 96859-5001

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