Provider Demographics
NPI:1942288774
Name:SENGER, KELLI DEANNE
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:DEANNE
Last Name:SENGER
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 1:16520 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5995
Mailing Address - Country:US
Mailing Address - Phone:425-742-8890
Mailing Address - Fax:
Practice Address - Street 1:16520 NORTH RD
Practice Address - Street 2:G106
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-5991
Practice Address - Country:US
Practice Address - Phone:425-742-8890
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00047465183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician