Kelvin K Ma MD Inc PS

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD00022157 Issued in WA

Legal business name

KELVIN K MA MD INC PS

Practice address

201 15TH Ave SW
Ste D
Puyallup, WA 98371-0226

Phone

(253) 840-0406

Fax

(253) 840-3352

NPI assigned

Sep 7, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelvin K Ma, MD

Title

President

Phone

(253) 840-0406

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1699878082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1148",
            "address_2": "201 15TH AVE SW STE D",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983710226",
            "telephone_number": "253-840-0406",
            "fax_number": "253-840-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 15TH AVE SW",
            "address_2": "STE D",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983710226",
            "telephone_number": "253-840-0406",
            "fax_number": "253-840-3352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981012756",
            "country_code": "US",
            "telephone_number": "206-223-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELVIN K MA MD INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "MA",
        "authorized_official_first_name": "KELVIN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-840-0406",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD00022157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0067266",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1302264",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya Kellerman
• Julia Elizabeth Kelley, FNP
• Kellie Eleazer
• Shannon Kelsch, AAHCC
• Paige Elizabeth Kelso-Znak, MSW
• Brooks F Kenderdine, DPT
• Thomas P Kennedy, MD
• Kenneth Hilliard DPM
• Kendra Elizabeth Mikatarian Kent, NP
• Penelope Anita Kent, OTR/L

• Neurology Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Neurology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.