Provider Demographics
NPI:1487816385
Name:KIRK, CHAD K (SOCIAL SCIENCE SPECI)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:K
Last Name:KIRK
Suffix:
Gender:M
Credentials:SOCIAL SCIENCE SPECI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 S COLUMBIAN WAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1532
Mailing Address - Country:US
Mailing Address - Phone:206-764-2630
Mailing Address - Fax:206-764-2225
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1597
Practice Address - Country:US
Practice Address - Phone:206-764-2630
Practice Address - Fax:206-764-2225
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health