Provider Demographics
NPI:1578078440
Name:MOZER, LAUREN MICHELLE (MPH, RDN, CD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MICHELLE
Last Name:MOZER
Suffix:
Gender:F
Credentials:MPH, RDN, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 FRANKLIN AVE E APT 202
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3458
Mailing Address - Country:US
Mailing Address - Phone:301-787-4431
Mailing Address - Fax:
Practice Address - Street 1:34920 ENCHANTED PKWY S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8325
Practice Address - Country:US
Practice Address - Phone:253-838-5878
Practice Address - Fax:253-838-1962
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60816160133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered