Individual
ANNA R KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2508 W SYLVESTER ST STE E, PASCO, WA 99301-4500
(509) 859-9058
Mailing address
2508 W SYLVESTER ST STE E, PASCO, WA 99301-4500
(509) 859-9058
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60442154
WA
Other
Enumeration date
04/30/2014
Last updated
12/01/2018
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