Healthcare Provider Details

I. General information

NPI: 1447075593
Provider Name (Legal Business Name): BRITTANY HOVSEPIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2024
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15026 40TH AVE W APT 12-301
LYNNWOOD WA
98087-8957
US

IV. Provider business mailing address

15026 40TH AVE W APT 12-301
LYNNWOOD WA
98087-8957
US

V. Phone/Fax

Practice location:
  • Phone: 360-540-2374
  • Fax:
Mailing address:
  • Phone: 360-540-2374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86199315
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: