Individual
DR. WILLIAM SAMUEL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9600 VETERANS DR SW, TACOMA, WA 98493-0003
(253) 583-1698
(253) 589-4167
Mailing address
9600 VETERANS DR SW, TACOMA, WA 98493-0003
(253) 583-1698
(253) 589-4167
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
33548
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2009646
—
WA
01
—
G8891457
MEDICARE W VALLEY MEDICAL GROUP - RENTON
WA
Enumeration date
08/17/2006
Last updated
03/10/2020
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