# KELLIE LEECLAIRE DUARTE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1306034277
- **Gender:** F
- **Credential:** M.ED, PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | RC00054737 | WA | — |
| 363A00000X | Physician Assistant | PA60610771 | WA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 1306034277 | WA | — |

## Other

- **Enumeration date:** 10/04/2007
- **Last updated:** 12/06/2017