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Individual

KELLY DAUSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MT(ASCP)

Contact information

Practice address
525 132ND ST SW APT S302, EVERETT, WA 98204-9376
(940) 765-9415
Mailing address
525 132ND ST SW APT S302, EVERETT, WA 98204-9376
(940) 765-9415

Taxonomy

Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
246QM0706X
Medical Technologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DAUSCHKT326N3
DRIVERS LICENSE
WA
Enumeration date
12/05/2016
Last updated
12/05/2016
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