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General NPI Number Information
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NPI Number | 1972828143
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Entity Type | Individual
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Provider Name | MARCIA ANITA KELLY MSW
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Gender | Female
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Dates
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Enumeration Date | 03/31/2010
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Last Update Date | 03/31/2010
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Provider Practice Location Address
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Address Line | 1600 S COLUMBIAN WAY MS -116-WTRC
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City | SEATTLE
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State | WA
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Zip | 98108-1565
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Country | US
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Telephone | 206-277-4016
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Fax | 206-764-2293
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Provider Business Mailing Address
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Address Line | 1600 S COLUMBIAN WAY MS -116-WTRC
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City | SEATTLE
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State | WA
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Zip | 98108-1565
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Country | US
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Telephone | 206-277-4016
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Fax | 206-764-2293
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW00007464
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License Number State | WA
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