Provider Demographics
NPI:1689622656
Name:DORSING, KAREN K (RD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:K
Last Name:DORSING
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 S STILLAGUAMISH AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1642
Mailing Address - Country:US
Mailing Address - Phone:360-435-2133
Mailing Address - Fax:360-435-0513
Practice Address - Street 1:330 S STILLAGUAMISH AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1642
Practice Address - Country:US
Practice Address - Phone:360-435-2133
Practice Address - Fax:360-435-0513
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001270133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA74222UOtherREGENCE BLUE SHIELD
WA8297392Medicaid