Individual
KELBY BIVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1802 YAKIMA AVE STE 302, TACOMA, WA 98405-5305
(253) 627-1244
(253) 627-6576
Mailing address
1802 YAKIMA AVE STE 302, TACOMA, WA 98405-5305
(253) 627-1244
(253) 627-6576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008617
GA
363A00000X
Physician Assistant
Primary
PA61308684
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2215095
—
WA
Enumeration date
11/13/2017
Last updated
01/05/2023
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