Individual
MRS. KELLY O'DONAUGHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3726 BROADWAY, SUITE 104, EVERETT, WA 98201-5030
(425) 252-4600
(425) 252-4477
Mailing address
10505 19TH AVE SE, STE B, EVERETT, WA 98208-4280
(408) 570-0510
(408) 945-4018
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00008837
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8371965
—
WA
Enumeration date
02/09/2007
Last updated
03/13/2013
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