Individual
MIRIAM KENNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1101 MADISON ST STE 301, SEATTLE, WA 98104-3599
(206) 505-1300
Mailing address
1101 MADISON ST STE 301, SEATTLE, WA 98104-3599
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD61057916
WA
Other
Enumeration date
03/31/2017
Last updated
07/28/2020
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