Provider Demographics
NPI:1225676406
Name:POLNEY, ERICA CATHERINE (MS RDN)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:CATHERINE
Last Name:POLNEY
Suffix:
Gender:F
Credentials:MS RDN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:CATHERINE
Other - Last Name:POLNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:322 22ND ST
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-1819
Mailing Address - Country:US
Mailing Address - Phone:512-964-3033
Mailing Address - Fax:
Practice Address - Street 1:5026 196TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6102
Practice Address - Country:US
Practice Address - Phone:425-740-8571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-18
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86090808133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered