ETHAN KELLY

TACOMA, WA
NPI1255088068
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208D00000X General Practice
(Licence: WI  82912-20)
Enumeration Date2022-03-02
Last Update Date2023-11-14
Business Address
ETHAN KELLY MD
9040 JACKSON AVE
TACOMA, WA 98431-0001
Phone number: 253-968-1250
Mailing Address
ETHAN KELLY MD
9040 JACKSON AVE
TACOMA, WA 98431-0001
Phone number: 253-968-1250
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