| Kelly Cornett | |
|
1455 Nw Leary Way Ste 400a Seattle WA 98107-5138 | |
| (425) 209-0828 | |
| Not Available |
| Full Name | Kelly Cornett |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1455 Nw Leary Way Ste 400a, Seattle, Washington |
| Authorized Official Name and Position | Kelly Akiko Cornett (OWNER/NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 4252090828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Cornett 2313 242nd Pl Sw Bothell WA 98021-9349 Ph: (425) 209-0828 | Kelly Cornett 1455 Nw Leary Way Ste 400a Seattle WA 98107-5138 Ph: (425) 209-0828 |
| NPI Number | 1912588088 |
|---|---|
| Provider Enumeration Date | 04/19/2021 |
| Last Update Date | 04/29/2021 |
| Certification Date | 04/29/2021 |
| Medicare PECOS PAC ID | 5395145379 |
|---|---|
| Medicare Enrollment ID | O20210614000287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912588088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Kelly Cornett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356789457 PECOS PAC ID: 5496051823 Enrollment ID: I20160311000569 |
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