Provider Demographics
NPI:1700420908
Name:DAVIS, JENNIFER ARPIN (RD, CD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ARPIN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 RUCKER AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2215
Mailing Address - Country:US
Mailing Address - Phone:406-698-0165
Mailing Address - Fax:
Practice Address - Street 1:4201 RUCKER AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2215
Practice Address - Country:US
Practice Address - Phone:425-789-3789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86147577133V00000X
WADI60986274133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered