1447355482 NPI number — DR. MARVIN I KUNIKIYO D.C.

Table of content: DR. MARVIN I KUNIKIYO D.C. (NPI 1447355482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447355482 NPI number — DR. MARVIN I KUNIKIYO D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUNIKIYO
Provider First Name:
MARVIN
Provider Middle Name:
I
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447355482
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5401 CORPORATE CENTER LOOP SE
Provider Second Line Business Mailing Address:
STE R
Provider Business Mailing Address City Name:
LACEY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98503-5606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-918-8782
Provider Business Mailing Address Fax Number:
360-972-2096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5401 CORPORATE CENTER LOOP SE
Provider Second Line Business Practice Location Address:
STE R
Provider Business Practice Location Address City Name:
LACEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98503-5606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-918-8782
Provider Business Practice Location Address Fax Number:
360-972-2096
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH00002656 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 173617 . This is a "LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com