MEDICARE: LYDIA D'ANTONA

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
1	133V00000X	Registered Dietitian	86053961	WA

General Provider Information

NPI Number	:	1285592444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYDIA D'ANTONA

Provider Business Mailing Address
First Line	:	3923 S MORGAN ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-3251
Country	:	US
Telephone Number	:	410-322-8060
Fax Number	:

Provider Business Practice Location Address
First Line	:	3923 S MORGAN ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-3251
Country	:	US
Telephone Number	:	410-322-8060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “ LYDIA D'ANTONA ” Practice Location

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