Provider Demographics
NPI:1063714582
Name:GAZORI, CAROLYN ZHALEH (RD, CDE)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ZHALEH
Last Name:GAZORI
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13723 PUGET PARK DR
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-9447
Mailing Address - Country:US
Mailing Address - Phone:425-337-0123
Mailing Address - Fax:425-316-8031
Practice Address - Street 1:13723 PUGET PARK DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-9447
Practice Address - Country:US
Practice Address - Phone:425-337-0123
Practice Address - Fax:425-316-8031
Is Sole Proprietor?:No
Enumeration Date:2010-12-04
Last Update Date:2010-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001135133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered