Provider Demographics
NPI:1871766758
Name:PULLIN, KIRSTEN M (MAC LAC)
Entity type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:M
Last Name:PULLIN
Suffix:
Gender:F
Credentials:MAC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1544 8TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3206
Mailing Address - Country:US
Mailing Address - Phone:202-302-4181
Mailing Address - Fax:
Practice Address - Street 1:8555 16TH ST
Practice Address - Street 2:SUITE 402
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2816
Practice Address - Country:US
Practice Address - Phone:202-302-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01646171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist