Dr Kelly Anne Supple, MD, MPH is a
Preventive Medicine - Occupational Medicine physician based in Arlington, Washington. Dr Kelly Anne Supple is licensed to practice in Washington (license number MD60364670) and her current practice location is 3823 - 172nd Street Ne, Cascade Skagit Health Alliance, Arlington, Washington. She can be reached at her office (for appointments etc.) via phone at
(360) 657-8700.
NPI number for Dr Kelly Anne Supple is 1861452534 and her current mailing address is 1400 E Kincaid St, Attn: Credentialing, Mount Vernon, Washington. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1861452534.
Physician's Profile
| Full Name | Dr Kelly Anne Supple |
|---|
| Gender | Female |
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| Speciality | Preventive Medicine - Occupational Medicine |
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| Location | 3823 - 172nd Street Ne, Arlington, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1861452534
- Provider Enumeration Date: 03/25/2006
- Last Update Date: 09/27/2013
Medical Identifiers
Medical identifiers for Dr Kelly Anne Supple such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861452534 | NPI | - | NPPES |
| 1861452534 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2083X0100X | Preventive Medicine - Occupational Medicine | 015816 (Maine) | Secondary |
| 207P00000X | Emergency Medicine | 102269 (Minnesota) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | MD60364670 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kelly Anne Supple is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kelly Anne Supple, MD, MPH
1400 E Kincaid St, Attn: Credentialing,
Mount Vernon, WA 98274-4127
Ph: (360) 428-2500 | Dr Kelly Anne Supple, MD, MPH
3823 - 172nd Street Ne, Cascade Skagit Health Alliance,
Arlington, WA 98223
Ph: (360) 657-8700 |
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