Provider Demographics
NPI:1881092872
Name:ANDERSON, ADAIR MARIE (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:ADAIR
Middle Name:MARIE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 OWEN PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2609
Mailing Address - Country:US
Mailing Address - Phone:571-353-1883
Mailing Address - Fax:
Practice Address - Street 1:601 I ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3735
Practice Address - Country:US
Practice Address - Phone:571-353-1883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000465133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered