Healthcare Provider Details

I. General information

NPI: 1780793653
Provider Name (Legal Business Name): KELLY SEKIKO KUNIYUKI-HIRAHARA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FAIRVIEW AVE E SUITE 302
SEATTLE WA
98102-3727
US

IV. Provider business mailing address

1500 FAIRVIEW AVE E SUITE 302
SEATTLE WA
98102-3727
US

V. Phone/Fax

Practice location:
  • Phone: 206-322-7706
  • Fax: 206-329-5214
Mailing address:
  • Phone: 206-322-7706
  • Fax: 206-329-5214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00010329
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE00010329
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: