Provider Demographics
NPI:1700655594
Name:KELSEY MARTELL DO PLLC
Entity Type:Organization
Organization Name:KELSEY MARTELL DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:509-612-3365
Mailing Address - Street 1:601 W 1ST AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-3813
Mailing Address - Country:US
Mailing Address - Phone:509-612-3365
Mailing Address - Fax:
Practice Address - Street 1:601 W 1ST AVE STE 1400
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3813
Practice Address - Country:US
Practice Address - Phone:509-612-3365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health