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General NPI Number Information
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NPI Number | 1154239416
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Entity Type | Organization
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Legal Business Name | GORDON KELCH DDS PLLC
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 3739 MT BAKER HWY
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City | EVERSON
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State | WA
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Zip | 98247-9406
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Country | US
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Telephone | 360-592-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 3739 MT BAKER HWY
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City | EVERSON
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State | WA
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Zip | 98247-9406
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Country | US
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Telephone | 224-623-3123
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | GORDON ALEXANDER KELCH
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Credential | DDS
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Telephone | 224-623-3123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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