Provider Demographics
NPI:1952612384
Name:BARRICK, KELSEY (DPM)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:BARRICK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 SE 117TH AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5297
Mailing Address - Country:US
Mailing Address - Phone:360-977-7815
Mailing Address - Fax:888-568-4875
Practice Address - Street 1:601 SE 117TH AVE STE 240
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5297
Practice Address - Country:US
Practice Address - Phone:360-977-7815
Practice Address - Fax:888-568-4875
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO60392076213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery