Provider Demographics
NPI:1720691561
Name:WETHERBEE, PAIGE (RDN)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:WETHERBEE
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 1:7701 FAIRWAY AVE SE UNIT 201
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-8933
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7701 FAIRWAY AVE SE UNIT 201
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-8933
Practice Address - Country:US
Practice Address - Phone:425-298-7364
Practice Address - Fax:888-932-5677
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-30
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI61108078133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered