Provider Demographics
NPI:1891550372
Name:LINDEN HALE NUTRITION LLC
Entity Type:Organization
Organization Name:LINDEN HALE NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:253-528-4979
Mailing Address - Street 1:13907 BIG SKY DR E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-5525
Mailing Address - Country:US
Mailing Address - Phone:253-528-4979
Mailing Address - Fax:
Practice Address - Street 1:13907 BIG SKY DR E
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-5525
Practice Address - Country:US
Practice Address - Phone:253-528-4979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health