Individual
MRS. SUSAN PETTY BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1660 S COLUMBIAN WAY, S-119-NFS, SEATTLE, WA 98108-1532
(206) 764-2253
(206) 764-2628
Mailing address
22009 39TH PLACE SOUTH, KENT, WA 98032
(206) 764-2253
(206) 764-2628
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
706276
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
706276
AMERICAN DIETETIC ASSOC
WA
Enumeration date
06/26/2006
Last updated
07/08/2007
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