Individual
KAITLIN M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4700 POINT FOSDICK DR STE 102, GIG HARBOR, WA 98335-1706
(253) 853-2050
(253) 853-2711
Mailing address
4700 POINT FOSDICK DR STE 102, GIG HARBOR, WA 98335-1706
(253) 853-2050
(253) 853-2711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60796422
WA
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
PA60796422
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2088986
—
WA
Enumeration date
09/05/2017
Last updated
10/26/2020
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