Provider Demographics
NPI:1962794719
Name:HIRATA, HONGBUNARETH (RDH)
Entity type:Individual
Prefix:
First Name:HONGBUNARETH
Middle Name:
Last Name:HIRATA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10022 62ND AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-2301
Mailing Address - Country:US
Mailing Address - Phone:206-473-1475
Mailing Address - Fax:
Practice Address - Street 1:6329 DISCOVERY ST E
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424
Practice Address - Country:US
Practice Address - Phone:206-473-1412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60221737225700000X
NMDB-2023-0041124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist