Provider Demographics
NPI:1487885638
Name:AUGUSTINE, JODI (RD, CD)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:
Last Name:AUGUSTINE
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:MS
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:FRAMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, CD
Mailing Address - Street 1:1500 FAIRVIEW AVE E
Mailing Address - Street 2:STE 205
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3727
Mailing Address - Country:US
Mailing Address - Phone:206-890-6901
Mailing Address - Fax:
Practice Address - Street 1:125 16TH AVE E
Practice Address - Street 2:A018
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5211
Practice Address - Country:US
Practice Address - Phone:206-326-3451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA985208133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADI60076272OtherWA DOH CERTIFICATION NUMBER