Individual
ABIGAIL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-3105
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-3105
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/28/2022
Last updated
08/03/2023
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