Provider Demographics
NPI:1831600030
Name:DAILY NUTRITION FOR LIFE LLC
Entity type:Organization
Organization Name:DAILY NUTRITION FOR LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:EDJLALI
Authorized Official - Suffix:
Authorized Official - Credentials:MS RDN CDE
Authorized Official - Phone:425-900-3606
Mailing Address - Street 1:15600 NE 8TH ST STE B1-707
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-3927
Mailing Address - Country:US
Mailing Address - Phone:425-900-3606
Mailing Address - Fax:
Practice Address - Street 1:15600 NE 8TH ST STE B1-707
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008
Practice Address - Country:US
Practice Address - Phone:425-830-1615
Practice Address - Fax:425-830-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty