Provider Demographics
NPI:1598818577
Name:HIRANO, KENDALL (PA)
Entity Type:Individual
Prefix:MR
First Name:KENDALL
Middle Name:
Last Name:HIRANO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15470 141ST PL SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-6364
Mailing Address - Country:US
Mailing Address - Phone:425-255-2869
Mailing Address - Fax:
Practice Address - Street 1:HHC 5-20 INF
Practice Address - Street 2:UNIT 5920
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09378
Practice Address - Country:US
Practice Address - Phone:000-000-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant