Individual
MRS. JESSICA ELLEN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2420 S STATE ST, TACOMA, WA 98405-2845
(253) 573-6113
Mailing address
7918 SE YOSEMITE, PORT ORCHARD, WA 98367
(253) 720-7998
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
61185982
WA
Other
Enumeration date
06/04/2021
Last updated
06/04/2021
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