Individual
VIVIENNE H DUTZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-5445
Mailing address
910 N WASHINGTON ST STE 209, SPOKANE, WA 99201-2260
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00000656
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
806663900
IDAHO MEDICAID
WA
05
—
8354631
—
WA
01
—
GAB32999
MEDICARE GROUP
WA
Enumeration date
04/26/2007
Last updated
10/21/2008
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