Individual
DONNECA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2426 S 224TH ST APT 104, DES MOINES, WA 98198-6644
(206) 403-5085
Mailing address
2426 S 224TH ST APT 104, DES MOINES, WA 98198-6644
(206) 403-5085
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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