Provider Demographics
NPI:1164661450
Name:HILLYER, ADRIAN W (LAC, LMP)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:W
Last Name:HILLYER
Suffix:
Gender:M
Credentials:LAC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53223
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015-3223
Mailing Address - Country:US
Mailing Address - Phone:425-463-9005
Mailing Address - Fax:
Practice Address - Street 1:12356 NORTHUP WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1956
Practice Address - Country:US
Practice Address - Phone:425-463-9005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60132448171100000X
WA60172725174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No174400000XOther Service ProvidersSpecialist