Diana Dericks

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC 60632595 Issued in WA

Practice address

515 Kirkland Way
Kirkland, WA 98033-6219

Phone

(970) 331-2583

NPI assigned

Mar 19, 2016

Last updated

Mar 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458345600000",
    "number": "1467813378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 BELMONT AVE E",
            "address_2": "APT 502",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981024873",
            "telephone_number": "970-331-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 KIRKLAND WAY",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336219",
            "telephone_number": "970-331-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERICKS",
        "first_name": "DIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-19",
        "last_updated": "2016-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC 60632595",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT60614280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronika Depoe
• Rebecca Deputy Crofoot, LMP
• Briauna Maureen Depuy
• Thomas Gerald Depuydt, M.D.
• Shanti Nichelle Der Blatter
• Dermavita Medispa
• Dominic Desanto, DPT
• Jeremie M Descartes
• Muktai Abhay Deshpande, BDS, MS
• Briana Marie Desmet, PA-C

• Acupuncturist in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Acupuncturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.