Organization
NEOGENESIS NUTRITION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER CHAMPION DCN, MS, CNS, CN, LD (OWNER)
(253) 507-5775
Entity
Organization
Contact information
Practice address
7018 59TH STREET CT W, UNIVERSITY PLACE, WA 98467-2172
(253) 507-5775
Mailing address
7018 59TH STREET CT W, UNIVERSITY PLACE, WA 98467-2172
(253) 507-5775
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
02/28/2023
Last updated
11/05/2025
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