Individual
MS. JENNIFER LYNN STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., C.D., C.N.S.D.
Contact information
Practice address
4800 SAND POINT WAY NE, M/S W3726, SEATTLE, WA 98105-3901
(206) 987-4339
(206) 987-5087
Mailing address
17200 116TH AVE SE, BOX 58215, RENTON, WA 98058-9997
(206) 987-4339
(206) 987-5087
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DI00000869
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8261752
—
WA
Enumeration date
10/12/2006
Last updated
07/08/2007
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