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Individual

KESLI ANNE DICKENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1702 TACOMA AVE S STE A, TACOMA, WA 98402-1700
(877) 522-1275
(833) 888-7145
Mailing address
500 SW 7TH ST STE A205, RENTON, WA 98057-2983
(877) 522-1275

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
149515
AK
363A00000X
Physician Assistant
Primary
PA61395609
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
149515
STATE OF ALASKA
AK
05
1704447
AK
Enumeration date
09/11/2018
Last updated
03/10/2025
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