Individual
KELLY LORRAINE WITTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
358 N MAIN ST, COLVILLE COMMUNITY HEALTH CLINIC, COLVILLE, WA 99114-2310
(509) 684-1440
(509) 684-2745
Mailing address
358 N MAIN ST, COLVILLE COMMUNITY HEALTH CLINIC, COLVILLE, WA 99114-2310
(509) 684-1440
(509) 684-2745
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
60697687
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/04/2015
Last updated
01/01/2017
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