Provider Demographics
NPI:1124780903
Name:ALKHATIB, RANEEM (CD)
Entity type:Individual
Prefix:
First Name:RANEEM
Middle Name:
Last Name:ALKHATIB
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 E MAIN STE D
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3199
Mailing Address - Country:US
Mailing Address - Phone:253-740-0977
Mailing Address - Fax:253-466-7072
Practice Address - Street 1:1004 E MAIN STE D
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3199
Practice Address - Country:US
Practice Address - Phone:253-740-0977
Practice Address - Fax:253-466-7072
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-09
Last Update Date:2021-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist