Provider Demographics
NPI:1417546623
Name:SAMAD, YASMEEN (RDN, CD)
Entity Type:Individual
Prefix:
First Name:YASMEEN
Middle Name:
Last Name:SAMAD
Suffix:
Gender:F
Credentials:RDN, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8311 HUNTS POINT PL
Mailing Address - Street 2:
Mailing Address - City:HUNTS POINT
Mailing Address - State:WA
Mailing Address - Zip Code:98004-1005
Mailing Address - Country:US
Mailing Address - Phone:206-499-2772
Mailing Address - Fax:
Practice Address - Street 1:550 17TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5789
Practice Address - Country:US
Practice Address - Phone:206-320-3494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA86089158133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered