Provider Demographics
NPI:1689714750
Name:KIRDAHY, DAVID P (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:KIRDAHY
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 1:2611 NE 125TH ST.
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125
Mailing Address - Country:US
Mailing Address - Phone:206-365-2233
Mailing Address - Fax:206-361-7082
Practice Address - Street 1:2611 NE 125TH ST
Practice Address - Street 2:SUITE 115
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4373
Practice Address - Country:US
Practice Address - Phone:206-365-2233
Practice Address - Fax:206-361-7082
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAKI1751Medicare UPIN