Provider Demographics
NPI:1407561558
Name:BARNES, COLTON ROLLAND (RD, CD)
Entity Type:Individual
Prefix:MR
First Name:COLTON
Middle Name:ROLLAND
Last Name:BARNES
Suffix:
Gender:M
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 1:1501 NW 56TH ST APT 824
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-0126
Mailing Address - Country:US
Mailing Address - Phone:419-591-9381
Mailing Address - Fax:
Practice Address - Street 1:1501 NW 56TH ST APT 824
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-0126
Practice Address - Country:US
Practice Address - Phone:419-591-9381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI61379597133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered