Individual
MR. MATTHEW GLEN KOONTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
10900 NE 4TH ST STE 2300, BELLEVUE, WA 98004-5882
(425) 633-2022
Mailing address
16550 NE 79TH ST APT 121, REDMOND, WA 98052-2474
(425) 633-2022
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
136A00000X
Registered Dietetic Technician
—
—
Other
Enumeration date
08/14/2020
Last updated
05/10/2023
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