Provider Demographics
NPI:1609288026
Name:HARRIS, CRISTEN (PHD, RDN)
Entity Type:Individual
Prefix:DR
First Name:CRISTEN
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:425-273-8577
Mailing Address - Fax:
Practice Address - Street 1:18221 102ND AVE NE
Practice Address - Street 2:SUITE A
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3466
Practice Address - Country:US
Practice Address - Phone:425-209-0593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DI60096825133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered