Provider Demographics
NPI:1336492099
Name:SAFTLER, SHARYN (RD)
Entity Type:Individual
Prefix:
First Name:SHARYN
Middle Name:
Last Name:SAFTLER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SHARYN
Other - Middle Name:
Other - Last Name:MOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:16609 NE 91ST ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3722
Mailing Address - Country:US
Mailing Address - Phone:253-260-4250
Mailing Address - Fax:
Practice Address - Street 1:16609 NE 91ST ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3722
Practice Address - Country:US
Practice Address - Phone:206-437-1910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI 60437740133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered