Healthcare Provider Details

I. General information

NPI: 1487729398
Provider Name (Legal Business Name): AMI KARNOSH CN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8266 LAKE CITY WAY #C3
SEATTLE WA
98115
US

IV. Provider business mailing address

8266 LAKE CITY WAY #C3
SEATTLE WA
98115-4475
US

V. Phone/Fax

Practice location:
  • Phone: 206-683-5083
  • Fax: 866-825-4679
Mailing address:
  • Phone: 206-683-5083
  • Fax: 866-825-4679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU00001760
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: