Individual
DIANA DERICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
515 KIRKLAND WAY, KIRKLAND, WA 98033-6219
(970) 331-2583
Mailing address
505 BELMONT AVE E, APT 502, SEATTLE, WA 98102-4873
(970) 331-2583
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 60632595
WA
175F00000X
Naturopath
NT60614280
WA
Other
Enumeration date
03/19/2016
Last updated
03/19/2016
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