Provider Demographics
NPI:1477278760
Name:TAYLOR-WALKER-WHITE, EBONY M (RDN)
Entity type:Individual
Prefix:
First Name:EBONY
Middle Name:M
Last Name:TAYLOR-WALKER-WHITE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:EBONY
Other - Middle Name:M
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN
Mailing Address - Street 1:32930 33RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2733
Mailing Address - Country:US
Mailing Address - Phone:253-820-2375
Mailing Address - Fax:
Practice Address - Street 1:32930 33RD AVE SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2733
Practice Address - Country:US
Practice Address - Phone:253-820-2375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered