Provider Demographics
NPI:1801355250
Name:ROBINSON, MARY ELIZABETH (MS, RD/LD, CDE)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS, RD/LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 19TH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2314
Mailing Address - Country:US
Mailing Address - Phone:361-500-2694
Mailing Address - Fax:
Practice Address - Street 1:1211 24TH ST
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2562
Practice Address - Country:US
Practice Address - Phone:360-299-1300
Practice Address - Fax:360-299-4241
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60360233133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered