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General NPI Number Information
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NPI Number | 1750570347
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Entity Type | Organization
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Legal Business Name | KELLEY POWERS AUDIOLOGY, P.S.
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 1800 COOKS HILL RD SUITE K
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City | CENTRALIA
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State | WA
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Zip | 98531-9068
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Country | US
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Telephone | 360-330-8944
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Fax | 360-330-8943
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Provider Business Mailing Address
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Address Line | 10016 LOOKOUT DR NW
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City | OLYMPIA
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State | WA
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Zip | 98502-9713
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Country | US
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Telephone | 360-330-8944
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Fax | 360-330-8943
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KELLEY A POWERS
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Credential | M.A.
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Telephone | 360-330-8944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | LD00002125
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License Number State | WA
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