Kelly Kalama Chie Shontell, | |
401 2nd St, Snohomish, WA 98290-3008 | |
(360) 563-8620 | |
Not Available |
Full Name | Kelly Kalama Chie Shontell |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 401 2nd St, Snohomish, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629538186 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 61277629 (Washington) | Primary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Entity Name | The Association Of University Physicians |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023041159 PECOS PAC ID: 0446162697 Enrollment ID: O20031105000244 |
Entity Name | The Association Of Chrmc And University Physicians |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255449963 PECOS PAC ID: 9133032964 Enrollment ID: O20031107000585 |
Entity Name | The Polyclinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174594634 PECOS PAC ID: 2163328196 Enrollment ID: O20031210000788 |
Entity Name | Optum Care Washington Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831186766 PECOS PAC ID: 6406752153 Enrollment ID: O20031211000922 |
Mailing Address | Practice Location Address |
---|---|
Kelly Kalama Chie Shontell, Po Box 5127, Everett, WA 98206-5127 Ph: (360) 563-8620 | Kelly Kalama Chie Shontell, 401 2nd St, Snohomish, WA 98290-3008 Ph: (360) 563-8620 |
Stephen Sher, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 401 2nd St, Snohomish, WA 98290 Phone: 360-563-8600 |