Provider Demographics
NPI:1194161349
Name:RICHARDS, RHIANNA (RD)
Entity type:Individual
Prefix:
First Name:RHIANNA
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:RHIANNA
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:413 SW WYCOFF RD
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-7296
Mailing Address - Country:US
Mailing Address - Phone:707-548-2193
Mailing Address - Fax:
Practice Address - Street 1:5112 NW TAYLOR RD
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-8837
Practice Address - Country:US
Practice Address - Phone:360-373-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1024146133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered