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Individual

MR. DEVAN KELSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
12911 SE KENT KANGLEY RD, KENT, WA 98030-7939
(253) 277-0029
Mailing address
PO BOX 1451, AUBURN, WA 98071-1451
(208) 553-1824

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 60369798
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1296672
AMTA
WA
Enumeration date
04/27/2016
Last updated
04/27/2016
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