Individual
MR. KELLEN AARON NOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1100 9TH AVE, MS:X7-NS, SEATTLE, WA 98101-2756
(206) 341-0182
(206) 341-0091
Mailing address
1100 9TH AVE, MS:M4-PFS, SEATTLE, WA 98101-2756
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00270600
NJ
363AS0400X
Surgical Physician Assistant
Primary
PA60373777
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851676118
—
WA
01
—
P01229427
RAILROAD
WA
Enumeration date
10/19/2011
Last updated
12/06/2013
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