Individual
KELSEY GULLICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 17TH AVE STE 540, SEATTLE, WA 98122-4470
(206) 386-3880
(206) 386-3882
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60904899
WA
363LG0600X
Gerontology Nurse Practitioner
AP60904899
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2141571
—
WA
01
—
AP60904899
WASHINGTON STATE NURSE PRACTITIONER LICENSE
WA
Enumeration date
03/15/2019
Last updated
12/07/2024
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