Provider Demographics
NPI:1962888057
Name:POWER, KELLIE JEAN
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:JEAN
Last Name:POWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 COWBOY LN
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-8513
Mailing Address - Country:US
Mailing Address - Phone:509-899-2977
Mailing Address - Fax:
Practice Address - Street 1:951 COWBOY LN
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-8513
Practice Address - Country:US
Practice Address - Phone:509-899-2977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist