KELLIE HERGENRADER
Physician Assistant
Active
Individual
NPI: 1447911540
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | No | - |
| Physician Assistant - Medical | 363AM0700X | No | - |
| Physician Assistant | 363A00000X | Yes | PA61479777 (WA) |
Frequently Asked Questions
NPI 1447911540 is the National Provider Identifier for KELLIE HERGENRADER, a Physician Assistant provider located in Port Townsend, WA. This NPI was enumerated on January 1, 2022.
KELLIE HERGENRADER practices at 915 SHERIDAN ST, Port Townsend, WA 98368.
Quick Facts
- NPI
- 1447911540
- Type
- Individual
- Enumerated
- Jan 1, 2022
- Last Updated
- Apr 16, 2024
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