Provider Demographics
NPI:1275886483
Name:GREY, KIRBY TEUILA (EAMP)
Entity Type:Individual
Prefix:
First Name:KIRBY
Middle Name:TEUILA
Last Name:GREY
Suffix:
Gender:F
Credentials:EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 16TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-5735
Mailing Address - Country:US
Mailing Address - Phone:206-403-5885
Mailing Address - Fax:
Practice Address - Street 1:3007 16TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-5735
Practice Address - Country:US
Practice Address - Phone:206-403-5885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist