Provider Demographics
NPI:1801335112
Name:GROCHOWSKI, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GROCHOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CONVENT AVE
Mailing Address - Street 2:APT 10
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-2602
Mailing Address - Country:US
Mailing Address - Phone:608-469-4373
Mailing Address - Fax:
Practice Address - Street 1:38579 SE RIVER STREET
Practice Address - Street 2:SUITE 15
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065
Practice Address - Country:US
Practice Address - Phone:425-445-3816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist