Provider Demographics
NPI:1215931001
Name:HIRANO, KEVIN Y (OD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:Y
Last Name:HIRANO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 SW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-7987
Mailing Address - Country:US
Mailing Address - Phone:425-888-8252
Mailing Address - Fax:619-789-4512
Practice Address - Street 1:24008 SNOHOMISH WOODINVILLE RD
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-9743
Practice Address - Country:US
Practice Address - Phone:425-888-8252
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3406152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU75983Medicare UPIN
CAU35434Medicare UPIN