Individual
MARY CLARE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.N.
Contact information
Practice address
6001 N MAYFAIR ST, SPOKANE, WA 99208-1129
(509) 462-2273
(509) 462-2275
Mailing address
PO BOX 996, HAYDEN, ID 83835-0996
(208) 664-4026
(855) 532-5921
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
86009851
WA
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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