Provider Demographics
NPI:1154683563
Name:CARD, BETHANY L (MS, RD)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:L
Last Name:CARD
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SW 39TH ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4915
Mailing Address - Country:US
Mailing Address - Phone:425-264-2584
Mailing Address - Fax:425-264-2569
Practice Address - Street 1:500 SW 39TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4915
Practice Address - Country:US
Practice Address - Phone:425-264-2584
Practice Address - Fax:425-264-2569
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered