Individual
MISS KELLY JEAN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
12900 NE 180TH ST STE 150, BOTHELL, WA 98011-5778
(206) 365-5484
(206) 365-5714
Mailing address
12900 NE 180TH ST STE 150, BOTHELL, WA 98011-5778
(206) 365-5484
(206) 365-5714
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000617
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1106699
—
WA
01
—
5815682
AETNA
WA
01
—
HA0967
REGENCE
WA
Enumeration date
09/16/2006
Last updated
08/07/2025
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