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General NPI Number Information
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NPI Number | 1427526375
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Entity Type | Individual
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Provider Name | JOSIE KELLY LMT
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Gender | Female
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Dates
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Enumeration Date | 11/08/2018
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 207 N DENNIS ST
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City | KENNEWICK
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State | WA
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Zip | 99336-3129
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Country | US
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Telephone | 509-551-0416
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Fax |
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Provider Business Mailing Address
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Address Line | 2608 S ANDERSON ST
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City | KENNEWICK
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State | WA
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Zip | 99337-2921
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Country | US
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Telephone | 509-212-6867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60894808
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License Number State | WA
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