Organization
ASTER NW SURGICAL ASSISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDEA KELLEY PA-C (OWNER)
(360) 588-8457
Entity
Organization
Contact information
Practice address
747 BROADWAY, SEATTLE, WA 98122-4379
(360) 588-8457
Mailing address
PO BOX 30549, SEATTLE, WA 98113-0549
(360) 588-8457
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
603409817
UBI
WA
Enumeration date
07/11/2014
Last updated
11/03/2014
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