Individual
KELLEN GUMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
122 W 7TH AVE STE 110, SPOKANE, WA 99204-2301
(509) 456-0262
(509) 462-5059
Mailing address
605 E HOLLAND AVE, STE 112, SPOKANE, WA 99218-1246
(509) 456-0262
(509) 462-5059
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA60798666
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/23/2016
Last updated
07/21/2022
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