Healthcare Provider Details

I. General information

NPI: 1962089771
Provider Name (Legal Business Name): KELLY DAUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 BROADWAY
SEATTLE WA
98122-4379
US

IV. Provider business mailing address

747 BROADWAY HEATH BUILDING, 10TH FLOOR
SEATTLE WA
98122
US

V. Phone/Fax

Practice location:
  • Phone: 206-836-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD70018956
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: