Provider Demographics
NPI:1306441712
Name:LOH, IVORY HONG (MPH, RDN)
Entity type:Individual
Prefix:
First Name:IVORY
Middle Name:HONG
Last Name:LOH
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:HONG
Other - Middle Name:
Other - Last Name:LOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1521 N 107TH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8931
Mailing Address - Country:US
Mailing Address - Phone:443-799-6557
Mailing Address - Fax:
Practice Address - Street 1:1521 N 107TH ST UNIT B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8931
Practice Address - Country:US
Practice Address - Phone:443-799-6557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered