Healthcare Provider Details

I. General information

NPI: 1356924252
Provider Name (Legal Business Name): KAYLEE KATRINA SALESKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 04/29/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

7120 WOODLAWN AVE NE APT 111
SEATTLE WA
98115-1429
US

V. Phone/Fax

Practice location:
  • Phone: 206-616-6996
  • Fax:
Mailing address:
  • Phone: 509-378-6409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: