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Individual
TIMOTHY L KELLY
Active
Individual
TIMOTHY L KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD00041959
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0197446
LABOR & IND
WA
05
—
213668
—
OR
05
—
8358756
—
WA
01
—
8905947
CRIME VICTIMS
WA
01
—
P00326179
RR MEDICARE
—
Enumeration date
08/23/2005
Last updated
11/08/2021
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