Individual
KELLY PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPC
Contact information
Practice address
21810 NE 37TH AVE, RIDGEFIELD, WA 98642-7747
(360) 980-2126
Mailing address
PO BOX 1299, BATTLE GROUND, WA 98604-1299
(360) 980-2126
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CG61349318
WA
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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