Healthcare Provider Details

I. General information

NPI: 1932326295
Provider Name (Legal Business Name): COURTNEY A. MCCLIMENT RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY A. TOFELL RD

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17307 SE 272ND ST STE 126
COVINGTON WA
98042-5306
US

IV. Provider business mailing address

17307 SE 272ND ST STE 126
COVINGTON WA
98042-5306
US

V. Phone/Fax

Practice location:
  • Phone: 425-690-3521
  • Fax: 425-690-9521
Mailing address:
  • Phone: 425-690-3521
  • Fax: 425-690-9521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI00001667
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: