Provider Demographics
NPI:1104167873
Name:BARNHOUSE, MARTHA JEAN (RD, CD)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:JEAN
Last Name:BARNHOUSE
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:JEAN
Other - Last Name:KOESKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:2020 E 29TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3948
Mailing Address - Country:US
Mailing Address - Phone:509-252-1366
Mailing Address - Fax:
Practice Address - Street 1:2020 E 29TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3948
Practice Address - Country:US
Practice Address - Phone:509-252-1366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60606670133V00000X
ORLDD10147787133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered