Provider Demographics
NPI:1669694691
Name:LAMERE, JUDITH LYNNE (RD, CD, CNSD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:LYNNE
Last Name:LAMERE
Suffix:
Gender:F
Credentials:RD, CD, CNSD
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:LYNNE
Other - Last Name:FARRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:3315 S 23RD ST
Practice Address - Street 2:STE 210
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1605
Practice Address - Country:US
Practice Address - Phone:253-572-8684
Practice Address - Fax:253-284-0450
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37000824A133V00000X
WADI60694539133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered