Provider Demographics
NPI:1497268304
Name:TUPPER, BRITTANY MAEJEAN (RDN)
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:MAEJEAN
Last Name:TUPPER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 BALD EAGLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:WA
Mailing Address - Zip Code:99156-3737
Mailing Address - Country:US
Mailing Address - Phone:509-254-3647
Mailing Address - Fax:
Practice Address - Street 1:251 BALD EAGLE DRIVE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:WA
Practice Address - Zip Code:99156-3737
Practice Address - Country:US
Practice Address - Phone:509-254-3647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
WADI60826408133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered