Individual
KATY MAY TAVOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5041 35TH AVE S, SEATTLE, WA 98118-1901
(206) 890-2967
Mailing address
5041 35TH AVE S, SEATTLE, WA 98118-1901
(206) 890-2967
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
NU60664807
WA
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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