Individual
MARY ELIZABETH DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CN
Contact information
Practice address
15965 NE 85TH ST STE 102, REDMOND, WA 98052-3593
(425) 882-9065
Mailing address
7903 170TH PL NE APT 103, REDMOND, WA 98052-4432
(302) 388-8518
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
NU60794847
WA
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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