Provider Demographics
NPI:1285038679
Name:HONDA, KATINA (LAC)
Entity Type:Individual
Prefix:
First Name:KATINA
Middle Name:
Last Name:HONDA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:KATINA
Other - Middle Name:
Other - Last Name:BRILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2825 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2638
Mailing Address - Country:US
Mailing Address - Phone:360-224-2171
Mailing Address - Fax:
Practice Address - Street 1:115 W MAGNOLIA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4300
Practice Address - Country:US
Practice Address - Phone:360-224-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-14
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60505252171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist