Healthcare Provider Details

I. General information

NPI: 1972989291
Provider Name (Legal Business Name): KRISTEN K THOMPSON RDN, CD, IFNCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2015
Last Update Date: 12/27/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16404 SMOKEY POINT BLVD STE 308
ARLINGTON WA
98223-7060
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 360-230-8202
  • Fax: 360-682-3732
Mailing address:
  • Phone: 630-296-2223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI 60584270
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: