Provider Demographics
NPI:1508570144
Name:SMITH, RILEY (RDN)
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20908 188TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-0556
Mailing Address - Country:US
Mailing Address - Phone:561-926-2352
Mailing Address - Fax:
Practice Address - Street 1:1314 AUBURN WAY N
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4109
Practice Address - Country:US
Practice Address - Phone:253-293-5734
Practice Address - Fax:206-299-0848
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI61325190133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered