Provider Demographics
NPI:1528211539
Name:BAILEY, NATALIA THERESA (MS, RD)
Entity Type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:THERESA
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 359790
Mailing Address - Street 2:325 NINTH AVE
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2499
Mailing Address - Country:US
Mailing Address - Phone:206-663-4638
Mailing Address - Fax:206-744-8540
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-663-4638
Practice Address - Fax:206-744-8540
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAD160045203133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered