Provider Demographics
NPI:1346139581
Name:FRY, KAILEY (NBC-HWC)
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:
Last Name:FRY
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:GOLDENDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98620-9022
Mailing Address - Country:US
Mailing Address - Phone:720-345-7303
Mailing Address - Fax:
Practice Address - Street 1:427 E COURT ST
Practice Address - Street 2:
Practice Address - City:GOLDENDALE
Practice Address - State:WA
Practice Address - Zip Code:98620-9022
Practice Address - Country:US
Practice Address - Phone:720-345-7303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach