Individual
KELLY STOCKDALE-NIELSEN
Active
Individual
KELLY STOCKDALE-NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005153
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48583
LABOR & INDUSTRIES
WA
05
—
8335937
—
WA
Enumeration date
09/25/2006
Last updated
04/24/2025
Update your record
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