Provider Demographics
NPI:1083122626
Name:PEVEN, KYE (ND, DSOM, EAMP)
Entity Type:Individual
Prefix:DR
First Name:KYE
Middle Name:
Last Name:PEVEN
Suffix:
Gender:M
Credentials:ND, DSOM, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 BURKE AVE N STE 360
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-9054
Mailing Address - Country:US
Mailing Address - Phone:206-531-2717
Mailing Address - Fax:833-974-2242
Practice Address - Street 1:3301 BURKE AVE N STE 360
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-9054
Practice Address - Country:US
Practice Address - Phone:206-531-2717
Practice Address - Fax:833-974-2242
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17881171100000X
WAAC60924576171100000X
CAND947175F00000X
WANT61010075175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist