Healthcare Provider Details

I. General information

NPI: 1205082211
Provider Name (Legal Business Name): ROSEMARIE ANN KENNALEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2008
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 214TH ST SE STE 205
BOTHELL WA
98021-4415
US

IV. Provider business mailing address

1728 W MARINE VIEW DR STE 110
EVERETT WA
98201-2094
US

V. Phone/Fax

Practice location:
  • Phone: 425-420-1657
  • Fax: 425-420-1644
Mailing address:
  • Phone: 425-259-4041
  • Fax: 425-740-4155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.MD.70120368
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: