Individual
BETSY M KEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
111 S 11TH AVE STE 320, YAKIMA, WA 98902-3273
(509) 454-8888
(509) 453-0061
Mailing address
PO BOX 2309, YAKIMA, WA 98907-2309
(509) 454-8888
(509) 453-0061
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA60231494
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2015046
—
WA
Enumeration date
09/20/2011
Last updated
01/26/2023
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