Provider Demographics
NPI:1376388231
Name:WETZLER, LISA CAY (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CAY
Last Name:WETZLER
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 S TAY ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-7005
Mailing Address - Country:US
Mailing Address - Phone:509-609-8393
Mailing Address - Fax:
Practice Address - Street 1:1116 E WESTVIEW CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1396
Practice Address - Country:US
Practice Address - Phone:509-468-8606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered