Organization
PROACTIVE NUTRITION, LLC
Active
Other names
ProActive Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY L HARA MS, RD (OWNER)
(425) 814-8443
Entity
Organization
Contact information
Practice address
13008 NE 125TH WAY, KIRKLAND, WA 98034-7726
(425) 814-8443
(425) 814-4852
Mailing address
13008 NE 125TH WAY, KIRKLAND, WA 98034-7726
(425) 814-8443
(425) 814-4852
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
602401604
WA
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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