Dr. Kelly R. White, M.D.
Family Medicine in Seattle, WA. Individual provider (NPI-1).
NPI number1528058542
StatusActive
Last updated in NPPESJun 25, 2021
Details
- NPI
- 1528058542
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kelly R. White
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 21, 2005
- Certification date
- Jun 25, 2021
- Last updated
- Jun 25, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | MD00032870 | WA | Yes |
| 208600000X | Surgery | MD00032870 | WA |
Practice location
5402 47th Ave NeSeattle, WA 98105-2927
Phone 206-219-1201
Mailing address
509 Olive WaySuite 900
Seattle, WA 98101-1720
Phone 206-860-4700 · Fax 206-624-9520
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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