Individual
KELLY ANNE SUDORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., B.S.N., D.C.
Contact information
Practice address
328 W MAIN ST, MONROE, WA 98272-1812
(360) 794-4500
(360) 863-1640
Mailing address
328 W MAIN ST, MONROE, WA 98272-1812
(360) 794-4500
(360) 863-1640
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00033602
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
402450
OTHER
WA
Enumeration date
02/07/2007
Last updated
07/09/2007
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