Most Relevant Information
Provider Data
| NPI Number: | 1003047796 |
| Provider Name: | KELLY A PHILLIPS D.O. |
| Entity Type: | Individual |
| Taxonomy Code: | 207P00000X |
| Specialty: | Emergency Medicine |
| License Number: | 4759 |
Most Important Dates
| Enumeration Date: | 07/29/2009 |
| Last Updated: | 09/09/2014 |
Provider Practice Location
11315 BRIDGEPORT WAY SW
EMERGENCY DEPT
LAKEWOOD
WA
984993004
Practice Location Phone/Fax
| Phone: | 2539858700 |
| Fax: |
Provider Mailing Location
11315 BRIDGEPORT WAY SW
EMERGENCY DEPT
LAKEWOOD
WA
984993004
Provider Mailing Phone/Fax
| Phone: | 2539858700 |
| Fax: |