Individual
KELSEY PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
751 NE BLAKELY DR, STE 4020, ISSAQUAH, WA 98029-6201
(425) 313-7124
(425) 313-7072
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(773) 318-8243
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0005626
MD
363AS0400X
Surgical Physician Assistant
Primary
PA60644257
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194122002
NPI
WA
Enumeration date
11/21/2014
Last updated
12/08/2016
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