Provider Demographics
NPI:1801614607
Name:CAZEL, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CAZEL
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 1:14542 75TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-4931
Mailing Address - Country:US
Mailing Address - Phone:773-653-0614
Mailing Address - Fax:
Practice Address - Street 1:19021 120TH AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-9511
Practice Address - Country:US
Practice Address - Phone:425-486-7710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI61607646133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered