Individual
KELLI JEAN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
608 NE 122ND AVE, VANCOUVER, WA 98684-5826
(360) 609-0560
Mailing address
608 NE 122ND AVE, VANCOUVER, WA 98684-5826
(360) 609-0560
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
175T00000X
Peer Specialist
Primary
—
WA
Other
Enumeration date
07/11/2018
Last updated
01/14/2019
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