White, Kelly R.

White, Kelly R. is an individual health care provider with primary practice located at 5402 47Th Ave Ne , Seattle WA 98105-2927. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. White, Kelly R. can be contacted via phone (206) 219-1201.

Contact Information

Primary practice address
5402 47Th Ave Ne Seattle WA 98105-2927
Phone: (206) 219-1201
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD00032870 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00032870 Washington

Profile Details

NPI number 1528058542
LBN Legal business name White, Kelly R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated Jun 25th, 2021 - about 5 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 1528058542 NPPES
Washington MEDICAID 8195471

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