Diane M Kelly, LMP

NPI #1083672406 in Vancouver, Washington

Provider Information

NPI Number: 1083672406
Entity Type: Individual
Name: Diane M Kelly, LMP
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Specialist
Credential: LMP
Enumeration Date: May 3, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 7902 NE ST JOHNS RD
City: Vancouver
State: Washington
ZIP Code: 98665-1094
Phone: (360) 573-6424

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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