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1760425201
MICHAEL C KELLY
OLYMPIA, WA
NPI
1760425201
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: WA AP30006322)
Enumeration Date
2006-06-13
Last Update Date
2021-07-06
Business Address
MICHAEL C KELLY NP
413 LILLY RD NE
OLYMPIA, WA 98506-5133
Phone number: 360-491-9480
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Mailing Address
MICHAEL C KELLY NP
PO BOX 5007
LACEY, WA 98509-5007
Phone number: 800-599-0166
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