Individual
DR. KELLEY A WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9040 JACKSAON AVE, TACOMA, WA 98431-0001
(253) 459-5161
Mailing address
9040 JACKSAON AVE, TACOMA, WA 98431-0001
(253) 459-5161
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD8054
HI
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD8054
HI
2080B0002X
Pediatric Obesity Medicine Physician
MD8054
HI
2080P0207X
Pediatric Hematology & Oncology Physician
MD8054
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000D06595
HMSA,HMSA QUEST,BCBS
HI
05
—
05727601
—
HI
01
—
753021507
HILB,HMA,HMAA
HI
01
—
MD805403
AET,NYLC,PBP,UHC,QHCP
HI
Enumeration date
06/23/2006
Last updated
07/16/2025
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