Organization
KEITH K LY, DO, P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH K LY DO (OWNER)
(425) 673-8000
Entity
Organization
Contact information
Practice address
6007 244TH ST SW # B, MOUNTLAKE TERRACE, WA 98043-5400
(425) 673-8000
(425) 673-9000
Mailing address
6007 244TH ST SW # B, MOUNTLAKE TERRACE, WA 98043-5400
(425) 673-8000
(425) 673-9000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00001670
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124254
—
WA
Enumeration date
07/11/2007
Last updated
11/14/2007
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