Provider Demographics
NPI:1285927020
Name:GRUENDER, GRETCHEN (MS, RD, CSO)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:GRUENDER
Suffix:
Gender:F
Credentials:MS, RD, CSO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10016 EDMONDS WAY, SUITE C-171
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-5924
Mailing Address - Country:US
Mailing Address - Phone:206-670-0118
Mailing Address - Fax:206-267-0073
Practice Address - Street 1:6522 N FREMONT AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5924
Practice Address - Country:US
Practice Address - Phone:206-670-0118
Practice Address - Fax:206-267-0073
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAD100001650133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered