Individual
MICHELE RENEE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
MADIGAN ARMY MEDICAL CTR, 9040 REID ST ATTN: MCHJ-QCR, TACOMA, WA 98431-1100
(253) 968-2252
(253) 968-3278
Mailing address
11515 212TH ST E, GRAHAM, WA 98338-6484
(210) 213-1576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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