Provider Demographics
NPI:1811547136
Name:CLOGSTON, MORGAN M (MS, RDN)
Entity Type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:M
Last Name:CLOGSTON
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:M
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6346 NE 194TH ST
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-3375
Mailing Address - Country:US
Mailing Address - Phone:360-440-0987
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:360-440-0987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric