Healthcare Provider Details

I. General information

NPI: 1538796487
Provider Name (Legal Business Name): HANNAH RIMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 03/23/2020
Certification Date: 03/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 W COURT ST
PASCO WA
99301-4153
US

IV. Provider business mailing address

PO BOX 1452
PASCO WA
99301-1223
US

V. Phone/Fax

Practice location:
  • Phone: 509-547-2204
  • Fax: 509-542-8836
Mailing address:
  • Phone: 509-543-1920
  • Fax: 509-542-8836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI61050218
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: