Individual
CELEZ SURATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
11216 SUNRISE BLVD E, SUITE 209, PUYALLUP, WA 98374-8848
(425) 778-2220
Mailing address
19930 BALLINGER WAY NE, SHORELINE, WA 98155-1223
(425) 778-2220
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60695986
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86006702
RD CERTIFICATION
WA
01
—
DI60695986
RD LICENSE
WA
Enumeration date
12/21/2016
Last updated
01/30/2018
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