Individual
RYAN MAYRUS KELSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DENTAL HYGENTIST
Contact information
Practice address
401 S MAIN ST, DEER PARK, WA 99006-8238
(509) 444-8200
(509) 444-7806
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
(509) 444-7806
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH60119564
WA
Other
Enumeration date
11/20/2009
Last updated
02/02/2022
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