Provider Demographics
NPI:1417449455
Name:NORTHWEST NUTRITION SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:NORTHWEST NUTRITION SOLUTIONS, PLLC
Other - Org Name:NORTHWEST NUTRITION SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ELEACIA
Authorized Official - Last Name:WALSER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CD
Authorized Official - Phone:509-844-5193
Mailing Address - Street 1:728 S MONROE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-3019
Mailing Address - Country:US
Mailing Address - Phone:509-844-5193
Mailing Address - Fax:
Practice Address - Street 1:1802 N MONROE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205
Practice Address - Country:US
Practice Address - Phone:509-844-5193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86060126133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty