Individual
KELLY LORANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1151 NW SAMMAMISH RD STE 101, ISSAQUAH, WA 98027-8937
(425) 369-1040
(425) 369-1041
Mailing address
14925 444TH AVE SE, NORTH BEND, WA 98045-9251
(425) 463-5800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60629754
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60629754
WA STATE DEPARTMENT OF LICENSE NUMBER
WA
Enumeration date
02/22/2016
Last updated
02/22/2016
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