Provider Demographics
NPI:1528572757
Name:FINAN, KELLY C (MS, RDN)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:C
Last Name:FINAN
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4504 241ST ST SW
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-5816
Mailing Address - Country:US
Mailing Address - Phone:425-283-8992
Mailing Address - Fax:
Practice Address - Street 1:4504 241ST ST SW
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-5816
Practice Address - Country:US
Practice Address - Phone:425-283-8992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA86072027133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA86072027OtherACADEMY OF NUTRITION AND DIETETICS