Provider Demographics
NPI:1063174993
Name:REED, KATHRYN (MS, CN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:MS, CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16816 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3638
Mailing Address - Country:US
Mailing Address - Phone:206-383-5284
Mailing Address - Fax:206-962-3155
Practice Address - Street 1:16816 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-3638
Practice Address - Country:US
Practice Address - Phone:206-383-5284
Practice Address - Fax:206-962-3155
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANU00001741133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist