Provider Demographics
NPI:1770629537
Name:HUGHES, DIANE MOIRA (DC)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:MOIRA
Last Name:HUGHES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:DIANE
Other - Middle Name:MOIRA
Other - Last Name:HUGHES-HART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13401 BEL RED RD
Mailing Address - Street 2:SUITE B12
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2322
Mailing Address - Country:US
Mailing Address - Phone:425-646-7475
Mailing Address - Fax:425-429-3288
Practice Address - Street 1:13401 BEL RED RD
Practice Address - Street 2:SUITE B12
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2322
Practice Address - Country:US
Practice Address - Phone:425-646-7475
Practice Address - Fax:425-429-3288
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2273111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG000102854Medicare UPIN