Individual
KELSEA KENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1950 NW MYHRE RD FL 3, SILVERDALE, WA 98383-7662
(564) 240-4200
(564) 240-4299
Mailing address
1950 NW MYHRE RD FL 3, SILVERDALE, WA 98383-7662
(564) 240-4200
(564) 240-4299
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA61283487
WA
363AM0700X
Medical Physician Assistant
MA060897
PA
363AS0400X
Surgical Physician Assistant
Primary
PA61283487
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2209721
—
WA
Enumeration date
07/31/2019
Last updated
09/21/2022
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