Healthcare Provider Details

I. General information

NPI: 1356263859
Provider Name (Legal Business Name): KELLIE-ANNE MARKELL AAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 MAIN ST STE 207
FERNDALE WA
98248-9060
US

IV. Provider business mailing address

6903 KICKERVILLE RD
FERNDALE WA
98248-5402
US

V. Phone/Fax

Practice location:
  • Phone: 360-230-8764
  • Fax:
Mailing address:
  • Phone: 360-230-8770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number70104584
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: