Provider Demographics
NPI:1083114870
Name:METZELAAR, KATHERINE ALENI (RDN, CD)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ALENI
Last Name:METZELAAR
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 1:205 19TH AVE E APT 206
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5355
Mailing Address - Country:US
Mailing Address - Phone:302-588-2731
Mailing Address - Fax:
Practice Address - Street 1:205 19TH AVE E APT 206
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5355
Practice Address - Country:US
Practice Address - Phone:302-588-2731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-18
Last Update Date:2018-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60711554133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered