Individual
KELLY BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 16TH AVE E, SEATTLE, WA 98112-5226
(425) 406-0445
Mailing address
201 16TH AVE E, SEATTLE, WA 98112-5226
(206) 326-4545
(206) 326-4555
Taxonomy
Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
Primary
RN60819967
WA
Other
Enumeration date
11/27/2023
Last updated
11/30/2023
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