Provider Demographics
NPI:1114548732
Name:HEIN, DIRK PHIROSE (PHD MAC (UK), LAC)
Entity Type:Individual
Prefix:DR
First Name:DIRK
Middle Name:PHIROSE
Last Name:HEIN
Suffix:
Gender:M
Credentials:PHD MAC (UK), LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 E BOSTON ST UNIT 100
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-3060
Mailing Address - Country:US
Mailing Address - Phone:206-324-4097
Mailing Address - Fax:
Practice Address - Street 1:2400 E BOSTON ST UNIT 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-3060
Practice Address - Country:US
Practice Address - Phone:206-324-4097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00000025171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist