Krizan, Kelly Joe

Krizan, Kelly Joe is an individual health care provider with primary practice located at 3417 Ensign Rd Ne , Olympia WA 98506-5064. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Krizan, Kelly Joe can be contacted via phone (360) 493-4600.

Contact Information

Primary practice address
3417 Ensign Rd Ne Olympia WA 98506-5064
Phone: (360) 493-4600
Fax: (360) 493-4603
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD00024212 Washington

Profile Details

NPI number 1881656841
LBN Legal business name Krizan, Kelly Joe
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Oct 15th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881656841 NPPES
Oregon MEDICAID 207097
Oregon MEDICAID 807397800
Oregon Other 5995KR
Oregon MEDICAID 8450025

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