Kelley, Alan Dewitt Kennett

Kelley, Alan Dewitt Kennett is an individual health care provider with primary practice located at 20200 54Th Ave W , Lynnwood WA 98036-6318. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kelley, Alan Dewitt Kennett can be contacted via phone (425) 672-6400.

Contact Information

Primary practice address
20200 54Th Ave W Lynnwood WA 98036-6318
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00023665 Washington

Profile Details

NPI number 1558343087
LBN Legal business name Kelley, Alan Dewitt Kennett
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated Apr 22nd, 2021 - about 4 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 1558343087 NPPES
Washington Other 080076957 MEDICARE RAILROAD
Washington Other KE9116 MEDICARE RAILROAD
Washington Other 104490 MEDICARE RAILROAD
Washington MEDICAID 1016815 MEDICARE RAILROAD

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