Provider Demographics
NPI:1912264375
Name:MORRISON, SARAH JANE (RD, CD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12618 100TH LN NE UNIT J147
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-8825
Mailing Address - Country:US
Mailing Address - Phone:520-403-4556
Mailing Address - Fax:
Practice Address - Street 1:13027 NE 70TH PL
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8630
Practice Address - Country:US
Practice Address - Phone:206-450-7423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60239066133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered