Individual
JENNIFER RENEE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
Mailing address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61328454
WA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
01/23/2022
Last updated
02/02/2023
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