Woodruff, Kelley A

Woodruff, Kelley A is an individual health care provider with primary practice located at 9040 Jacksaon Ave , Tacoma WA 98431-0001. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Woodruff, Kelley A can be contacted via phone (253) 459-5161.

Contact Information

Primary practice address
9040 Jacksaon Ave Tacoma WA 98431-0001
Phone: (253) 459-5161
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X MD8054 Hawaii
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD8054 Hawaii

Profile Details

NPI number 1619903416
LBN Legal business name Woodruff, Kelley A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Dec 31st, 2019 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1619903416 NPPES
Hawaii Other MD805403 AET,NYLC,PBP,UHC,QHCP
Hawaii MEDICAID 05727601 AET,NYLC,PBP,UHC,QHCP
Hawaii Other 0000D06595 AET,NYLC,PBP,UHC,QHCP
Hawaii Other 753021507 AET,NYLC,PBP,UHC,QHCP

Popular Providers