Provider Demographics
NPI:1295342426
Name:POMORSKI, CLAIRE (RD)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:POMORSKI
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 1:996 S 200 E APT 108
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-4253
Mailing Address - Country:US
Mailing Address - Phone:814-823-6692
Mailing Address - Fax:
Practice Address - Street 1:996 S 200 E APT 108
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-4253
Practice Address - Country:US
Practice Address - Phone:814-823-6692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty