Individual
SIGNE KELSA PARENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
844 6TH ST, CLARKSTON, WA 99403-2013
(509) 444-8200
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH-2441
ID
124Q00000X
Dental Hygienist
Primary
DH60241153
WA
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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