Provider Demographics
NPI:1043441827
Name:BUZZELLI, ANNE (MS RD CD CBP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:BUZZELLI
Suffix:
Gender:F
Credentials:MS RD CD CBP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:BUZZELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:142 N 75TH ST
Mailing Address - Street 2:#7
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4648
Mailing Address - Country:US
Mailing Address - Phone:206-497-5326
Mailing Address - Fax:206-309-7493
Practice Address - Street 1:5801 PHINNEY AVE N
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5862
Practice Address - Country:US
Practice Address - Phone:206-497-5326
Practice Address - Fax:206-309-7493
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1001464133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered