Provider Demographics
NPI:1124758859
Name:FORBESS, DANI A (NTP)
Entity type:Individual
Prefix:
First Name:DANI
Middle Name:A
Last Name:FORBESS
Suffix:
Gender:F
Credentials:NTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 W FRENCHGLEN DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-7525
Mailing Address - Country:US
Mailing Address - Phone:206-883-7856
Mailing Address - Fax:
Practice Address - Street 1:5000 W FRENCHGLEN DR
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-7525
Practice Address - Country:US
Practice Address - Phone:206-883-7856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist