Provider Demographics
NPI:1326462318
Name:DENNETT, CARRIE CATHLEEN (MPH, RDN)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:CATHLEEN
Last Name:DENNETT
Suffix:
Gender:F
Credentials:MPH, RDN
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 1311
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-0072
Mailing Address - Country:US
Mailing Address - Phone:206-601-8537
Mailing Address - Fax:
Practice Address - Street 1:758 W OREGON AVE
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1943
Practice Address - Country:US
Practice Address - Phone:206-601-8537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60452579133V00000X
ORLD-D-10196596133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered