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Organization

DYNAMIC NUTRITION NW LLC

Active
Other names
Dynamic Nutrition NW, Dynamic Nutrition NW LLC
Organization subpart
No

Provider details

NPI number
Authorized official
EVANGELIA FACCHINE RD, CD (OWNER)
(732) 986-2633
Entity
Organization

Contact information

Practice address
5811 187TH AVE SE, ISSAQUAH, WA 98027-8620
(425) 470-3458
(425) 372-7941
Mailing address
5811 187TH AVE SE, ISSAQUAH, WA 98027-8620
(425) 470-3458
(425) 372-7941

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1255995973
NPI
Enumeration date
03/10/2021
Last updated
03/10/2021
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