Healthcare Provider Details

I. General information

NPI: 1033035605
Provider Name (Legal Business Name): RHIAN KAIDID HENDRICKS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6363 7TH AVE S
SEATTLE WA
98108-3407
US

IV. Provider business mailing address

5624 CALIFORNIA AVE SW APT 103
SEATTLE WA
98136-1533
US

V. Phone/Fax

Practice location:
  • Phone: 206-517-4541
  • Fax:
Mailing address:
  • Phone: 951-205-8144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: