Provider Demographics
NPI:1285819490
Name:HARRIS, ASHLEY A (RD, CD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:HARRIS
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 1:9726 SE 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-3802
Mailing Address - Country:US
Mailing Address - Phone:206-403-8922
Mailing Address - Fax:
Practice Address - Street 1:10532 NE 68TH ST
Practice Address - Street 2:SUITE D203
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7097
Practice Address - Country:US
Practice Address - Phone:206-491-8188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00002066133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered