Individual
MR. DANIEL JOSEPH KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD00022665
WA
207W00000X
Ophthalmology Physician
Primary
MD12291
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1257104
WASH WELF
WA
05
—
267104
—
OR
Enumeration date
04/19/2006
Last updated
03/07/2023
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