Individual
DR. LYLE DUANE KELSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6202 NE HIGHWAY 99, #5, VANCOUVER, WA 98665-8747
(360) 693-2592
(360) 750-7939
Mailing address
6202 NE HIGHWAY 99, #5, VANCOUVER, WA 98665-8747
(360) 693-2592
(360) 750-7939
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE00004874
WA
1223G0001X
General Practice Dentistry
Primary
DE00004874
WA
Other
Enumeration date
04/18/2007
Last updated
02/21/2025
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