Provider Demographics
NPI:1093895971
Name:MCSPERITT, DEBIE (RDN, CD)
Entity Type:Individual
Prefix:MS
First Name:DEBIE
Middle Name:
Last Name:MCSPERITT
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 1:807 ALOHA ST
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-3161
Mailing Address - Country:US
Mailing Address - Phone:360-434-0499
Mailing Address - Fax:
Practice Address - Street 1:807 ALOHA ST
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3161
Practice Address - Country:US
Practice Address - Phone:360-434-0499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001557133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADI00001557OtherLICENSE