Individual
DR. JONATHAN MICHAEL KELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
(253) 761-4201
Mailing address
PO BOX 1535, TACOMA, WA 98401-1535
(253) 761-4200
(253) 383-3553
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00047121
WA
2085R0202X
Diagnostic Radiology Physician
MD189438
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0240804
LNI-DIAGNOSTIC IMAGING NW
WA
01
—
0363434
LNI-TRA REST OF WA
WA
01
—
0363435
LNI-TRA KING COUNTY
WA
01
—
0363436
LNI-UNION AVENUE OPEN MRI
WA
05
—
1012880
—
WA
Enumeration date
09/20/2006
Last updated
08/30/2024
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