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Individual

KELLIE SROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
20640 84TH AVE S, KENT, WA 98032-1224
(253) 395-1171
Mailing address
3255 115TH AVE NE, APT 255, BELLEVUE, WA 98004-7794
(904) 563-1817

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60323116
WA

Other

Enumeration date
11/05/2013
Last updated
11/05/2013
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