Provider Demographics
NPI:1558650341
Name:YAMANAKA, KIMBERLY JEANNE (RD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JEANNE
Last Name:YAMANAKA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:JEANNE
Other - Last Name:WARFEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12501 BEL RED RD
Mailing Address - Street 2:STE 210
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2509
Mailing Address - Country:US
Mailing Address - Phone:206-450-7423
Mailing Address - Fax:206-309-5195
Practice Address - Street 1:12501 BEL RED RD
Practice Address - Street 2:STE 210
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2509
Practice Address - Country:US
Practice Address - Phone:206-450-7423
Practice Address - Fax:206-309-5195
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA992771133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered