MEDICARE: KELLY R GARWOOD DDS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1528925815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KELLY R GARWOOD DDS PLLC

Provider Business Mailing Address
First Line	:	PO BOX 372
Second Line	:
City	:	NORTH BEND
State	:	WA
Zip	:	98045-0372
Country	:	US
Telephone Number	:	425-888-0867
Fax Number	:	425-888-6585

Provider Business Practice Location Address
First Line	:	142 MAIN AVE N
Second Line	:
City	:	NORTH BEND
State	:	WA
Zip	:	98045-8280
Country	:	US
Telephone Number	:	425-888-0867
Fax Number	:	425-888-6585

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KELLY RAE GARWOOD
Credential	:	DDS
Telephone Number	:	425-888-0867

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/14/2026

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