Healthcare Provider Details

I. General information

NPI: 1043441827
Provider Name (Legal Business Name): ANNE BUZZELLI MS RD CD CBP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA BUZZELLI

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 05/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 PHINNEY AVE N SUITE 100
SEATTLE WA
98103-5862
US

IV. Provider business mailing address

142 N 75TH ST #7
SEATTLE WA
98103-4648
US

V. Phone/Fax

Practice location:
  • Phone: 206-497-5326
  • Fax: 206-309-7493
Mailing address:
  • Phone: 206-497-5326
  • Fax: 206-309-7493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1001464
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: