Provider Demographics
NPI:1528753829
Name:NOURISHED SEED NUTRITION, PLLC
Entity type:Organization
Organization Name:NOURISHED SEED NUTRITION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:360-218-4348
Mailing Address - Street 1:4287 SHOKOWAKAN RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:WA
Mailing Address - Zip Code:98236-8731
Mailing Address - Country:US
Mailing Address - Phone:360-218-4348
Mailing Address - Fax:425-249-3367
Practice Address - Street 1:11314 4TH AVE W STE 108
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-6926
Practice Address - Country:US
Practice Address - Phone:360-218-4348
Practice Address - Fax:425-249-3367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty