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General NPI Number Information
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NPI Number | 1548735749
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Entity Type | Individual
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Provider Name | KELSEY MARKHAM POPE APRN
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Gender | Female
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Dates
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Enumeration Date | 10/04/2018
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 7100 FORT DENT WAY STE 220
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City | TUKWILA
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State | WA
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Zip | 98188-8553
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Country | US
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Telephone | 206-708-7274
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Fax |
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Provider Business Mailing Address
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Address Line | 13822 PARKVIEW DR E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-5233
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Country | US
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Telephone | 901-496-3123
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 24859
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 61107142
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License Number State | WA
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