Provider Demographics
NPI:1336962745
Name:NUTRITION BY CARRIE
Entity type:Organization
Organization Name:NUTRITION BY CARRIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:DENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:206-601-8537
Mailing Address - Street 1:3647 PARULA RD
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-8769
Mailing Address - Country:US
Mailing Address - Phone:206-601-8537
Mailing Address - Fax:
Practice Address - Street 1:3647 PARULA RD
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-8769
Practice Address - Country:US
Practice Address - Phone:206-601-8537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty