Provider Demographics
NPI:1043853815
Name:NADIR, DIONEA SYLVANA (LAC)
Entity type:Individual
Prefix:
First Name:DIONEA
Middle Name:SYLVANA
Last Name:NADIR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15314 4TH AVE SW STE A
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2340
Mailing Address - Country:US
Mailing Address - Phone:206-246-1310
Mailing Address - Fax:
Practice Address - Street 1:15314 4TH AVE SW STE A
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2340
Practice Address - Country:US
Practice Address - Phone:206-246-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist