Provider Demographics
NPI:1518021997
Name:KINIRY, EDWIN WALTER (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:WALTER
Last Name:KINIRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2036
Mailing Address - Country:US
Mailing Address - Phone:206-323-2426
Mailing Address - Fax:206-323-2472
Practice Address - Street 1:423 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2036
Practice Address - Country:US
Practice Address - Phone:206-323-2426
Practice Address - Fax:206-323-2472
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor