Individual
DR. KELLY R. WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5402 47TH AVE NE, SEATTLE, WA 98105-2927
(206) 219-1201
Mailing address
509 OLIVE WAY, SUITE 900, SEATTLE, WA 98101-1720
(206) 860-4700
(206) 624-9520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00032870
WA
208600000X
Surgery Physician
MD00032870
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8195471
—
WA
Enumeration date
10/21/2005
Last updated
06/25/2021
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