# NORTHWESTERN MEDICAL CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northwestern Lifestyle Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699809533
- **Authorized official:** MRS. MARY PIGEON (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (802) 524-8954

## Contact information

- **Practice address:** 260 CREST RD, SUITE 202, SAINT ALBANS, VT 05478-9503
- **Practice address phone:** (802) 524-1227
- **Practice address fax:** (802) 524-8498
- **Mailing address:** 133 FAIRFIELD ST, SAINT ALBANS, VT 05478-1726
- **Mailing address phone:** (802) 524-1227
- **Mailing address fax:** (802) 524-8498

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | Yes |
| 133NN1002X | Nutrition Education Nutritionist | — | — | Yes |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 136A00000X | Registered Dietetic Technician | — | NULL | — |
| 136A00000X | Registered Dietetic Technician | — | — | — |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 10/23/2018