Individual
DR. KELLY JOE KRIZAN
Active
Individual
DR. KELLY JOE KRIZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00024212
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207097
—
OR
01
—
5995KR
REGENCE BLUE SHIELD
WA
05
—
807397800
—
ID
05
—
8450025
—
WA
Enumeration date
04/05/2006
Last updated
10/15/2010
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