Provider Demographics
NPI:1558758409
Name:KHAIRA, KIRAN (ND, MA)
Entity Type:Individual
Prefix:
First Name:KIRAN
Middle Name:
Last Name:KHAIRA
Suffix:
Gender:F
Credentials:ND, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 STONE WAY N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8004
Mailing Address - Country:US
Mailing Address - Phone:206-834-4100
Mailing Address - Fax:
Practice Address - Street 1:3670 STONE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8004
Practice Address - Country:US
Practice Address - Phone:206-834-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2092175F00000X
WANT 60583712175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath