Provider Demographics
NPI:1427187129
Name:NUTRITIONWORKS
Entity Type:Organization
Organization Name:NUTRITIONWORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PUTNAM
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD
Authorized Official - Phone:206-729-2633
Mailing Address - Street 1:2901 NE BLAKELEY ST STE 3B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3168
Mailing Address - Country:US
Mailing Address - Phone:206-729-2633
Mailing Address - Fax:206-729-2636
Practice Address - Street 1:2901 NE BLAKELEY ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3164
Practice Address - Country:US
Practice Address - Phone:206-729-2633
Practice Address - Fax:206-729-2636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00000689133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty