Provider Demographics
NPI:1437295433
Name:HASTINGS, DIANE K
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:K
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6805 141ST ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8961
Mailing Address - Country:US
Mailing Address - Phone:360-568-8737
Mailing Address - Fax:360-568-1654
Practice Address - Street 1:621 164TH ST SE
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-6303
Practice Address - Country:US
Practice Address - Phone:425-670-2120
Practice Address - Fax:360-568-1654
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002611106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist