Provider Demographics
NPI:1942832464
Name:HUNT, JEANI (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:JEANI
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:JEANI
Other - Middle Name:
Other - Last Name:HUNT-GIBBON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6021 27TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7111
Mailing Address - Country:US
Mailing Address - Phone:415-963-2430
Mailing Address - Fax:
Practice Address - Street 1:6021 27TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-7111
Practice Address - Country:US
Practice Address - Phone:415-963-2430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61028433133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered