Provider Demographics
NPI:1811531718
Name:CLASBY, JENNICA ANN (RDN)
Entity type:Individual
Prefix:MRS
First Name:JENNICA
Middle Name:ANN
Last Name:CLASBY
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 1:18828 SMOKEY POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8266
Mailing Address - Country:US
Mailing Address - Phone:360-454-5280
Mailing Address - Fax:
Practice Address - Street 1:18828 SMOKEY POINT BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8266
Practice Address - Country:US
Practice Address - Phone:360-454-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal