# KELLEY M. WASHINGTON DDS,PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Washington Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174826937
- **Authorized official:** DR. KELLEY MICHAEL WASHINGTON DDS (PRESIDENT/DENTIST)
- **Authorized official phone:** (206) 722-8211

## Contact information

- **Practice address:** 4543 RAINIER AVE S, SEATTLE, WA 98118-1656
- **Practice address phone:** (206) 722-8211
- **Practice address fax:** (206) 722-3249
- **Mailing address:** 4543 RAINIER AVE S, SEATTLE, WA 98118-1656
- **Mailing address phone:** (206) 722-8211
- **Mailing address fax:** (206) 722-3249

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 9721 | WA | Yes |

## Other

- **Enumeration date:** 12/15/2010
- **Last updated:** 12/15/2010