Provider Demographics
NPI:1841837762
Name:JONES, ERYN KELSI (RD, LD)
Entity type:Individual
Prefix:
First Name:ERYN
Middle Name:KELSI
Last Name:JONES
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 SW 299TH PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3573
Mailing Address - Country:US
Mailing Address - Phone:425-879-2403
Mailing Address - Fax:
Practice Address - Street 1:608 SW 299TH PL
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-3573
Practice Address - Country:US
Practice Address - Phone:425-879-2403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-10
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13080139-4901133V00000X
ORLD-D-10194334133V00000X
WADI-60895620133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered