Individual
KELLY ELIZABETH ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1512 SPRECKELS ST, HONOLULU, HI 96822-4658
(206) 910-3621
Mailing address
1512 SPRECKELS ST, HONOLULU, HI 96822-4658
(206) 910-3621
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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