Individual
MARA ANDRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10333 SW 116TH ST, VASHON, WA 98070-3080
(206) 819-5100
Mailing address
10333 SW 116TH ST, VASHON, WA 98070-3080
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI 00001645
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16210
AMERICAN DIETETIC ASSOCIATION
—
01
—
DI 00001645
STATE DIETITIAN CERTIFICATION
WA
Enumeration date
03/20/2014
Last updated
03/20/2014
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