Organization
EVERGREEN PEDIATRIC NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARI MAZON RDN (BUSINESS OWNER)
(425) 835-2256
Entity
Organization
Contact information
Practice address
2440 FERNDALE PL NE, RENTON, WA 98056-8374
(425) 835-2256
Mailing address
2440 FERNDALE PL NE, RENTON, WA 98056-8374
(425) 835-2256
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
05/29/2026
Last updated
05/29/2026
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