Provider Demographics
NPI:1215733415
Name:KOPFLER, KATHERINE HALL (RDN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:HALL
Last Name:KOPFLER
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13520 WEMBLEY RD
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:LA
Mailing Address - Zip Code:70437-3126
Mailing Address - Country:US
Mailing Address - Phone:206-854-0803
Mailing Address - Fax:
Practice Address - Street 1:13520 WEMBLEY RD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:LA
Practice Address - Zip Code:70437-3126
Practice Address - Country:US
Practice Address - Phone:206-854-0803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3469133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered