Individual
KIM LYNNE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9610 168TH STREET CT E, PUYALLUP, WA 98375-2256
(253) 840-8881
(253) 840-8992
Mailing address
302 2ND ST SE, PUYALLUP, WA 98372-3220
(253) 840-8881
(253) 840-8992
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00037551
WA
Other
Enumeration date
01/04/2013
Last updated
01/04/2013
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