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Individual

MRS. SHELLEY RENE SWENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, CD

Contact information

Practice address
10808 NE 145TH ST, BOTHELL, WA 98011-5200
(425) 296-9820
Mailing address
21921 40TH AVE SE, BOTHELL, WA 98021-7983
(425) 256-2184

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
943031
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8443624
WA
Enumeration date
12/06/2006
Last updated
07/08/2007
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