Healthcare Provider Details

I. General information

NPI: 1881124048
Provider Name (Legal Business Name): MARGO ANN ELBERT RDN, CD, HSMI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 07/21/2022
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 COLUMBIA ST STE 400
SEATTLE WA
98104-2053
US

IV. Provider business mailing address

1124 COLUMBIA ST STE 400
SEATTLE WA
98104-2053
US

V. Phone/Fax

Practice location:
  • Phone: 206-215-2090
  • Fax:
Mailing address:
  • Phone: 206-215-2090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number940870
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number940870
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number940870
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: