Individual
MS. KELLY A OSBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS PT
Contact information
Practice address
10004 204TH AVE E, STE 3100, BONNEY LAKE, WA 98391-6539
(253) 863-7510
(253) 863-5970
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00006442
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0291100
DEPT. OF LABOR AND INDUSTRIES
WA
01
—
158113
DEPT OF L&I
WA
01
—
5342OB
REGENCE BS
WA
01
—
650023301
R/R MED PC
WA
05
—
8334062
—
WA
01
—
8936257
CRIME VICTIMS
WA
Enumeration date
08/18/2005
Last updated
07/14/2015
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