Provider Demographics
NPI:1710410097
Name:COULTER, ALLIE (RD, CD)
Entity type:Individual
Prefix:
First Name:ALLIE
Middle Name:
Last Name:COULTER
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 1:17307 SE 272ND ST STE 126
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-5306
Mailing Address - Country:US
Mailing Address - Phone:425-690-3521
Mailing Address - Fax:425-690-9521
Practice Address - Street 1:17307 SE 272ND ST STE 126
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-5306
Practice Address - Country:US
Practice Address - Phone:425-690-3521
Practice Address - Fax:425-690-9521
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60531242133NN1002X
WADI 60531242133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered