Provider Demographics
NPI:1932447497
Name:HOFFMAN, JESSICA DOTY (RD, CD)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:DOTY
Last Name:HOFFMAN
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 1:34030 SE STROUF ST
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-8735
Mailing Address - Country:US
Mailing Address - Phone:425-231-8376
Mailing Address - Fax:
Practice Address - Street 1:4205 148TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-7114
Practice Address - Country:US
Practice Address - Phone:425-202-6041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI 60314212133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered