Provider Demographics
NPI:1386060754
Name:PARSONS, REBECCA (MS, RD, CD, CES)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:PARSONS
Suffix:
Gender:F
Credentials:MS, RD, CD, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 KENYON ST NW STE 1
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4578
Mailing Address - Country:US
Mailing Address - Phone:360-358-3179
Mailing Address - Fax:888-974-6419
Practice Address - Street 1:222 KENYON ST NW STE 1
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502
Practice Address - Country:US
Practice Address - Phone:360-358-3179
Practice Address - Fax:888-974-6419
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI604171412133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered