Individual
MS. KELLY DENISE VAN HORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1124 COLUMBIA ST STE 400, SEATTLE, WA 98104-2053
(206) 215-2440
(206) 215-2457
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
DI00001827
WA
133V00000X
Registered Dietitian
Primary
DI00001827
WA
133V00000X
Registered Dietitian
HC00152963
WA
Other
Enumeration date
12/19/2007
Last updated
03/17/2018
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