Provider Demographics
NPI:1558772855
Name:AIM 2 NOURISH, LLC
Entity Type:Organization
Organization Name:AIM 2 NOURISH, LLC
Other - Org Name:DR. CRISTEN HARRIS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SINGLE MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RDN, CSSD, CD
Authorized Official - Phone:425-273-8577
Mailing Address - Street 1:18779 KENLAKE PL NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-3236
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18779 KENLAKE PL NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-3236
Practice Address - Country:US
Practice Address - Phone:425-273-8577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60096825133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty