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Individual

KIM MARIE KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
1401 BOMBING RANGE RD, WEST RICHLAND, WA 99353-8001
(509) 967-8008
(509) 967-8096
Mailing address
1401 BOMBING RANGE RD, WEST RICHLAND, WA 99353-8001
(509) 967-8008
(509) 967-8096

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00015160
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6029136
WA
Enumeration date
08/26/2013
Last updated
08/26/2013
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