Individual
DARRYL MATHEW KELLEHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S.P.T.
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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