# SAGE WISDOM NUTRITION LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386029858
- **Authorized official:** SOPHIA L TASLER BSN (PROVIDER/OWNER)
- **Authorized official phone:** (253) 951-4820

## Contact information

- **Practice address:** 1019 PACIFIC AVE, SUITE 801, TACOMA, WA 98402-4443
- **Practice address phone:** (253) 254-6945
- **Mailing address:** PO BOX 97115, LAKEWOOD, WA 98497-0115
- **Mailing address phone:** (253) 588-7911
- **Mailing address fax:** (253) 365-6299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | DI60417979 | WA | Yes |

## Other

- **Enumeration date:** 07/27/2015
- **Last updated:** 07/27/2015