Provider Demographics
NPI:1881422632
Name:HERNANDEZ GONZALEZ, XIMENA (RDN)
Entity type:Individual
Prefix:MS
First Name:XIMENA
Middle Name:
Last Name:HERNANDEZ GONZALEZ
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 1:821 233RD PL NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-7287
Mailing Address - Country:US
Mailing Address - Phone:425-449-9729
Mailing Address - Fax:
Practice Address - Street 1:821 233RD PL NE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7287
Practice Address - Country:US
Practice Address - Phone:425-449-9729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86434633133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered