Individual
ALLISON NICOLE KELLEHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
747 BROADWAY, SEATTLE, WA 98122-4307
(206) 386-6000
Mailing address
747 BROADWAY, SEATTLE, WA 98122-4307
(206) 386-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DEUW.DR.61141247
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
DEUW.DR.61141247
WA
Other
Enumeration date
03/15/2021
Last updated
03/31/2021
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