Provider Demographics
NPI:1083086508
Name:PUHEK, LAUREN MARGARET (MS RDN CD)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:MARGARET
Last Name:PUHEK
Suffix:
Gender:F
Credentials:MS RDN CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1912 S VERA CREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:VERADALE
Mailing Address - State:WA
Mailing Address - Zip Code:99037
Mailing Address - Country:US
Mailing Address - Phone:509-868-1580
Mailing Address - Fax:888-664-0363
Practice Address - Street 1:325 S UNIVERISTY ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99206
Practice Address - Country:US
Practice Address - Phone:509-868-1580
Practice Address - Fax:888-664-0363
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60602252133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered