Provider Demographics
NPI:1336293075
Name:BEVE KINDBLADE CONSULTING
Entity Type:Organization
Organization Name:BEVE KINDBLADE CONSULTING
Other - Org Name:SEATTLE NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NUTRITIONIST, REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:KINDBLADE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CD
Authorized Official - Phone:206-920-7676
Mailing Address - Street 1:1904 3RD AVE
Mailing Address - Street 2:SUITE 935
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1191
Mailing Address - Country:US
Mailing Address - Phone:206-920-7676
Mailing Address - Fax:
Practice Address - Street 1:1904 3RD AVE
Practice Address - Street 2:SUITE 935
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1191
Practice Address - Country:US
Practice Address - Phone:206-920-7676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00000649133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty