Healthcare Provider Details

I. General information

NPI: 1659841823
Provider Name (Legal Business Name): KIRSTEN ALYSE RAMSDELL CN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2018
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 BELLEVUE AVE STE A
SEATTLE WA
98122-6820
US

IV. Provider business mailing address

12572 CORLISS AVE N
SEATTLE WA
98133-8566
US

V. Phone/Fax

Practice location:
  • Phone: 206-734-8370
  • Fax: 206-237-0773
Mailing address:
  • Phone: 206-450-6132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU60906188
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: