Individual
KELLY K MALUEG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1519 ALASKAN WAY S, BASE SEATTLE MEDICAL, SEATTLE, WA 98134-1102
(206) 217-6432
(206) 217-6636
Mailing address
1519 ALASKAN WAY S, BASE SEATTLE MEDICAL, SEATTLE, WA 98134-1102
(206) 217-6432
(206) 217-6636
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2448
OR
152W00000X
Optometrist
Primary
3054
WA
152W00000X
Optometrist
858
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2016582
—
WA
Enumeration date
11/01/2006
Last updated
06/05/2013
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