Provider Demographics
NPI:1194033472
Name:RHODEN, EMILY RUTH (RD, CD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RUTH
Last Name:RHODEN
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 1:4207 141ST ST SE
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8942
Mailing Address - Country:US
Mailing Address - Phone:425-327-1740
Mailing Address - Fax:
Practice Address - Street 1:13723 PUGET PARK DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-9447
Practice Address - Country:US
Practice Address - Phone:425-337-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAD160123451133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered