Mary Clare Kelley, R.D.N.

Primary specialty

Registered Dietetic TechnicianTaxonomy code 136A00000X

License

86009851 Issued in WA

Practice address

6001 N Mayfair St
Spokane, WA 99208-1129

Phone

(509) 462-2273

Fax

(509) 462-2275

NPI assigned

Jan 13, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1881083988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 996",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838350996",
            "telephone_number": "208-664-4026",
            "fax_number": "855-532-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 N MAYFAIR ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081129",
            "telephone_number": "509-462-2273",
            "fax_number": "509-462-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MARY CLARE",
        "credential": "R.D.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "WA",
            "license": "86009851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Griffith Kelley, CCC-SLP
• Christopher Garner Kelley, CRNA
• Jamie Lynn Kelley, F.N.P.
• Keith Thomas Kelley, BA
• Lisa Kelley, SLP
• Rhonda Elaine Kelley, DPT
• Emily Jewel Kellogg
• Glenn Kellogg, MD
• Kortney Kellogg, PHARMD
• Pamela Kellogg

• Registered Dietetic Technician in Spokane, WA
• Providers in Spokane, WA by specialty
• Registered Dietetic Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.