Provider Demographics
NPI:1083725865
Name:QUINTON, CYNAMON (RD, CD)
Entity Type:Individual
Prefix:MRS
First Name:CYNAMON
Middle Name:
Last Name:QUINTON
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22607 141ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-3846
Mailing Address - Country:US
Mailing Address - Phone:253-850-1192
Mailing Address - Fax:253-630-2292
Practice Address - Street 1:3915 TALBOT RD S
Practice Address - Street 2:SUITE 200
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5738
Practice Address - Country:US
Practice Address - Phone:253-350-4477
Practice Address - Fax:253-630-2292
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001592133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered