Provider Demographics
NPI:1699338525
Name:LENKER, MARIAH (RDN, CD)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:LENKER
Suffix:
Gender:F
Credentials:RDN, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 SCENIC DR SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-6404
Mailing Address - Country:US
Mailing Address - Phone:253-315-5480
Mailing Address - Fax:
Practice Address - Street 1:1002 39TH AVE SW STE 200
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3813
Practice Address - Country:US
Practice Address - Phone:855-328-4543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60932749133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered