Individual
DARRYL MATHEW KELLEHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S.P.T.
Contact information
Practice address
3711 PACIFIC AVE STE 101, TACOMA, WA 98418-7800
(253) 475-4415
(253) 475-3034
Mailing address
3711 PACIFIC AVE STE 101, TACOMA, WA 98418-7800
(253) 475-4415
(253) 475-3034
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00002811
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2378617
AETNA HMO, QPOS US ACCESS
WA
01
—
32331
DEPT OF L AND I
WA
01
—
336786200
US DEPT OF LABOR-OWCP-ACS
WA
01
—
4454296
AETNA PPO, POS, EPO
WA
01
—
650016424
RAILROAD MEDICARE
WA
05
—
7160054
—
WA
05
—
8333940
—
WA
01
—
8914810
CRIME VICTIMS L AND I
WA
01
—
8914812
SOUNDVIEW CRIMEVICTIMSLI
WA
01
—
KE0554
REGENCE BLUE SHIELD
WA
Enumeration date
08/31/2006
Last updated
07/09/2007
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