Provider Demographics
NPI:1285647990
Name:SATUR, GLORIA (MS, RD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:SATUR
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:PO BOX 1452
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-0160
Mailing Address - Country:US
Mailing Address - Phone:360-779-0079
Mailing Address - Fax:360-779-0079
Practice Address - Street 1:18820 FRONT STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370
Practice Address - Country:US
Practice Address - Phone:360-779-0079
Practice Address - Fax:360-779-0079
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA020710 D100001348133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7601081Medicaid
WAAB32708Medicare ID - Type UnspecifiedPROVIDER #