Provider Demographics
NPI:1366951261
Name:HOPKINS, KELSEA (PA-C MS RDN)
Entity type:Individual
Prefix:MRS
First Name:KELSEA
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:PA-C MS RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15605 E SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-8901
Mailing Address - Country:US
Mailing Address - Phone:509-598-7820
Mailing Address - Fax:
Practice Address - Street 1:15605 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037-8901
Practice Address - Country:US
Practice Address - Phone:509-598-7820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86081622133V00000X
1206904363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
1206904OtherNCCPA
86081622OtherRDN
ORLD-D-101844099OtherLICENCED DIETITIAN OREGON