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NPI Code Detail

MEDICARE: KELLEY ROBERT BRANCH

MEDICARE: KELLEY ROBERT BRANCH
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
1207RC0000XCardiovascular Disease PhysicianMD00039926WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10230851OTHERWAL&I
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3224210OTHERINTERNAL ID-MOTOR VEHICLE ID

General Provider Information

NPI Number : 1760572622
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY ROBERT BRANCH
Provider Business Mailing Address
First Line : PO BOX 50095
Second Line :
City : SEATTLE
State : WA
Zip : 98145-5095
Country : US
Telephone Number : 206-543-6420
Fax Number :
Provider Business Practice Location Address
First Line : UNIVERSITY OF WASHINGTON MEDICAL CTR
Second Line : 1959 NE PACIFIC ST
City : SEATTLE
State : WA
Zip : 98195-6043
Country : US
Telephone Number : 206-598-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 09/06/2012

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