Individual
KELSIE LOREHA OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
1107 S 16TH AVE, YAKIMA, WA 98902-5331
(509) 574-6822
(509) 574-4732
Mailing address
PO BOX 22520, YAKIMA, WA 98907-2520
(509) 574-6822
(509) 574-4732
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160047338
WA
Other
Enumeration date
04/09/2012
Last updated
04/09/2012
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