Provider Demographics
NPI:1518608066
Name:PHILLIPS, KELE
Entity Type:Individual
Prefix:
First Name:KELE
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELE
Other - Middle Name:
Other - Last Name:OSBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 ORONDO AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2800
Mailing Address - Country:US
Mailing Address - Phone:509-664-0949
Mailing Address - Fax:509-664-4590
Practice Address - Street 1:140 EASY WAY
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-8108
Practice Address - Country:US
Practice Address - Phone:509-662-4296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor