Provider Demographics
NPI:1528467180
Name:FLORES, KIRA LOVE
Entity type:Individual
Prefix:MRS
First Name:KIRA
Middle Name:LOVE
Last Name:FLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1723 100TH PL SE STE E
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3800
Mailing Address - Country:US
Mailing Address - Phone:425-327-6776
Mailing Address - Fax:
Practice Address - Street 1:1723 100TH PL SE STE E
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3800
Practice Address - Country:US
Practice Address - Phone:425-327-6776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60203085106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist