Provider Demographics
NPI:1356163000
Name:SUMMIT NUTRITION COUNSELING PLLC
Entity type:Organization
Organization Name:SUMMIT NUTRITION COUNSELING PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:LUCERO
Authorized Official - Last Name:OLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:425-405-0161
Mailing Address - Street 1:21312 SE 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-9547
Mailing Address - Country:US
Mailing Address - Phone:425-405-0161
Mailing Address - Fax:425-307-6114
Practice Address - Street 1:21312 SE 24TH ST
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075-9547
Practice Address - Country:US
Practice Address - Phone:425-657-6050
Practice Address - Fax:425-307-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty