Individual
KELLI JO BLAISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11702 YELM HWY SE, OLYMPIA, WA 98513-9109
(360) 459-9603
Mailing address
10478 GLACIER CT, JOINT BASE LEWIS MCCHORD, WA 98433-1345
(804) 433-1040
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
61686076
WA
Other
Enumeration date
12/29/2025
Last updated
12/29/2025
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