Provider Demographics
NPI:1952681884
Name:LAMAR, STEPHANIE B (RD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:B
Last Name:LAMAR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 TERRY AVE
Mailing Address - Street 2:MAILSTOP: X1-DTC
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2735
Mailing Address - Country:US
Mailing Address - Phone:206-223-6729
Mailing Address - Fax:206-583-6417
Practice Address - Street 1:1201 TERRY AVE
Practice Address - Street 2:MAILSTOP: X1-DTC
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2735
Practice Address - Country:US
Practice Address - Phone:206-223-6729
Practice Address - Fax:206-583-6417
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60240095133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered