Healthcare Provider Details

I. General information

NPI: 1568833184
Provider Name (Legal Business Name): KELLEY CADE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4909 25TH AVE NE SUITE 120
SEATTLE WA
98105-4107
US

IV. Provider business mailing address

4909 25TH AVE NE SUITE 120
SEATTLE WA
98105-4107
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-8080
  • Fax:
Mailing address:
  • Phone: 206-987-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: