Organization
NUTRITION AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE DOUGLAS RDN (CEO)
(855) 328-4543
Entity
Organization
Contact information
Practice address
3712 9TH ST SW, SUITE 1A, PUYALLUP, WA 98373-3564
(855) 328-4543
Mailing address
3712 9TH ST SW, SUITE 1A, PUYALLUP, WA 98373-3564
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
60610914
WA
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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