Individual
LISABETH CARLISLE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3919 N MAPLE ST, SPOKANE, WA 99205-1349
(509) 444-8200
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61467593
WA
207R00000X
Internal Medicine Physician
A110776
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A110776
MEDICAL LICENSE
CA
Enumeration date
07/02/2008
Last updated
10/05/2023
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