Provider Demographics
NPI:1457865826
Name:SPOTTSWOOD, KATHRYN ZACHERETTI (RD)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ZACHERETTI
Last Name:SPOTTSWOOD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ANN
Other - Last Name:ZACHERETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10222 167TH PL NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3124
Mailing Address - Country:US
Mailing Address - Phone:901-355-0034
Mailing Address - Fax:
Practice Address - Street 1:10222 167TH PL NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3124
Practice Address - Country:US
Practice Address - Phone:901-355-0034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60731654133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty