Provider Demographics
NPI:1285069344
Name:TASLER, SOPHIA LYANN (RD)
Entity type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:LYANN
Last Name:TASLER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SOUTH G STREET
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4758
Mailing Address - Country:US
Mailing Address - Phone:253-254-6945
Mailing Address - Fax:
Practice Address - Street 1:309 S G STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4758
Practice Address - Country:US
Practice Address - Phone:253-254-6945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA86006604133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered