Individual
DR. MICHAEL M KENNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16233 SYLVESTER RD SW STE 110, BURIEN, WA 98166-3044
(206) 901-8980
Mailing address
16233 SYLVESTER RD SW STE 110, BURIEN, WA 98166-3044
(206) 901-8980
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00021678
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005224
—
WA
Enumeration date
03/17/2006
Last updated
12/04/2020
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