Provider Demographics
NPI:1740209782
Name:KOLAHI, M. KAY (RD)
Entity Type:Individual
Prefix:
First Name:M.
Middle Name:KAY
Last Name:KOLAHI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:M.
Other - Middle Name:KAY
Other - Last Name:HELMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 24366
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0366
Mailing Address - Country:US
Mailing Address - Phone:206-598-0502
Mailing Address - Fax:206-598-0516
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-598-4163
Practice Address - Fax:206-598-2592
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00000242133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU06421OtherREGENCE BLUESHIELD
P54966Medicare UPIN
WAU06421OtherREGENCE BLUESHIELD