Provider Demographics
NPI:1598562308
Name:KEILMAN, KELSEY ANNE (NP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANNE
Last Name:KEILMAN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 42ND AVE SW
Mailing Address - Street 2:APT 104
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116
Mailing Address - Country:US
Mailing Address - Phone:574-302-7594
Mailing Address - Fax:
Practice Address - Street 1:32114 1ST AVE S STE 203
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003
Practice Address - Country:US
Practice Address - Phone:253-838-0219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61666676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily