Provider Demographics
NPI:1255456075
Name:SIMMS, ERIN ELIZABETH (RD, CD, CNSD, CDE)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:SIMMS
Suffix:
Gender:F
Credentials:RD, CD, CNSD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-9623
Mailing Address - Country:US
Mailing Address - Phone:360-221-6504
Mailing Address - Fax:
Practice Address - Street 1:101 N MAIN ST
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239-3413
Practice Address - Country:US
Practice Address - Phone:360-678-7656
Practice Address - Fax:360-678-7684
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB32135Medicare ID - Type Unspecified