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NPI Code Detail

MEDICARE: DANDELION NUTRITION LLC

MEDICARE: DANDELION NUTRITION LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianDI60202010WA

General Provider Information

NPI Number : 1285046292
Entity Type Code : Organization
Provider Name (Legal Business Name) : DANDELION NUTRITION LLC
Provider Business Mailing Address
First Line : 8301B 5TH AVE NE
Second Line :
City : SEATTLE
State : WA
Zip : 98115-4118
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8301B 5TH AVE NE
Second Line :
City : SEATTLE
State : WA
Zip : 98115-4118
Country : US
Telephone Number : 206-799-7010
Fax Number : 206-866-0204
Authorized Official
Title or Position : CEO
Name : SUNG HYUN MO
Credential :
Telephone Number : 201-790-6643
Provider Enumeration Date : 05/25/2014
Last Update Date : 05/06/2026

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Directions to “DANDELION NUTRITION LLC ” Practice Location

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