Provider Demographics
NPI:1346079167
Name:ROYER, KELLYN (MA)
Entity type:Individual
Prefix:
First Name:KELLYN
Middle Name:
Last Name:ROYER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 N ARGONNE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-6011
Mailing Address - Country:US
Mailing Address - Phone:425-681-0494
Mailing Address - Fax:
Practice Address - Street 1:1050 N ARGONNE RD STE 100
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-6011
Practice Address - Country:US
Practice Address - Phone:425-681-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator