Individual
KELLY RENEE BRASWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 949-9292
Mailing address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 949-9292
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
60339791
WA
Other
Enumeration date
06/28/2020
Last updated
06/28/2020
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