Provider Demographics
NPI:1053777193
Name:ASAHI KIRIN, LLC
Entity type:Organization
Organization Name:ASAHI KIRIN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:DAHIR
Authorized Official - Last Name:LY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D, LMHC
Authorized Official - Phone:802-589-0111
Mailing Address - Street 1:2018 156TH AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3825
Mailing Address - Country:US
Mailing Address - Phone:802-589-0111
Mailing Address - Fax:
Practice Address - Street 1:2018 156TH AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3825
Practice Address - Country:US
Practice Address - Phone:802-589-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health