Provider Demographics
NPI:1821202730
Name:ADLER, JENNIFER E (MS, CN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:ADLER
Suffix:
Gender:F
Credentials:MS, CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 WESTERN AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3605
Mailing Address - Country:US
Mailing Address - Phone:206-595-0376
Mailing Address - Fax:
Practice Address - Street 1:911 WESTERN AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3605
Practice Address - Country:US
Practice Address - Phone:206-595-0376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANU00001572133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education