Provider Demographics
NPI:1912360033
Name:HOBBS, LANE GUYSE (MS, RD, CD)
Entity Type:Individual
Prefix:
First Name:LANE
Middle Name:GUYSE
Last Name:HOBBS
Suffix:
Gender:F
Credentials:MS, RD, CD
Other - Prefix:
Other - First Name:LANE
Other - Middle Name:ALISON
Other - Last Name:GUYSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LN
Mailing Address - Street 1:2100 S 285TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-3319
Mailing Address - Country:US
Mailing Address - Phone:253-225-0360
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:X1-DTC
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60642520133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
942008OtherCOMMISSION ON DIETETIC REGISTRATION
WADI60642520OtherDIETITIAN CERTIFICATION