Provider Demographics
NPI:1619529203
Name:REEVES, EMILY ELIZABETH BROWN (PHD CNS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ELIZABETH BROWN
Last Name:REEVES
Suffix:
Gender:F
Credentials:PHD CNS
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:ELIZABETH
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD CNS
Mailing Address - Street 1:2020 SHAMROCK DR NW
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-2510
Mailing Address - Country:US
Mailing Address - Phone:979-703-9608
Mailing Address - Fax:
Practice Address - Street 1:2020 SHAMROCK DR NW
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-2510
Practice Address - Country:US
Practice Address - Phone:979-703-9608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
17777133N00000X
133VN1006X, 133VN1201X, 170100000X, 133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
Provider Identifiers
StateIdentifier IDID TypeIssuer
17777OtherBOARD FOR CERTIFICATION OF NUTRITION SPECIALISTS