Individual
SALLY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
310 15TH AVE E, SEATTLE, WA 98112-5103
(206) 326-3000
Mailing address
PO BOX 34581, SEATTLE, WA 98124-1581
(509) 241-7349
(509) 241-7628
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00000519
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233347
L&I
WA
05
—
8271462
—
WA
Enumeration date
02/16/2007
Last updated
08/12/2009
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