Provider Demographics
NPI:1275661126
Name:DOTTAI, ANNE M (MS, RD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:DOTTAI
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 1:2101 186TH PL SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8709
Mailing Address - Country:US
Mailing Address - Phone:425-330-1961
Mailing Address - Fax:
Practice Address - Street 1:602 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2589
Practice Address - Country:US
Practice Address - Phone:425-330-1961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001807133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered