Individual
KELLY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
325 9TH AVE, BOX 359790, SEATTLE, WA 98104-2420
(206) 744-5004
Mailing address
325 9TH AVE, BOX 359790, SEATTLE, WA 98104-2420
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1105841
WA
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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