Supple, Kelly Anne

Supple, Kelly Anne is an individual health care provider with primary practice located at 3823 - 172Nd Street Ne Cascade Skagit Health Alliance, Arlington WA 98223. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Occupational Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Occupational Medicine is her primary health care specialty. Supple, Kelly Anne can be contacted via phone (360) 657-8700.

Contact Information

Primary practice address
3823 - 172Nd Street Ne Cascade Skagit Health Alliance Arlington WA 98223
Phone: (360) 657-8700
Fax: (360) 657-8717
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 015816 Maine
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 102269 Minnesota
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X MD60364670 Washington

Profile Details

NPI number 1861452534
LBN Legal business name Supple, Kelly Anne
Credentials MD, MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Sep 27th, 2013 - about 12 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 1861452534 NPPES
Washington MEDICAID 1861452534

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