Provider Demographics
NPI:1689619637
Name:RICE, KIRIN MARIE (DO)
Entity Type:Individual
Prefix:
First Name:KIRIN
Middle Name:MARIE
Last Name:RICE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S 336TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6328
Mailing Address - Country:US
Mailing Address - Phone:253-838-6180
Mailing Address - Fax:253-838-6418
Practice Address - Street 1:34515 9TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6761
Practice Address - Country:US
Practice Address - Phone:253-838-9700
Practice Address - Fax:253-944-7922
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP0001243207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARU1186OtherBSWA
WA0170827OtherLIWA
WA0170817OtherLIWA
WA8308363Medicaid
OR288206Medicaid
WARU1985OtherBSWA
WA0170827OtherLIWA
WARU1186OtherBSWA
WA8308363Medicaid
WARU1985OtherBSWA