Healthcare Provider Details
I. General information
NPI: 1285046292
Provider Name (Legal Business Name): DANDELION NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2014
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8301B 5TH AVE NE
SEATTLE WA
98115-4118
US
IV. Provider business mailing address
8301B 5TH AVE NE
SEATTLE WA
98115-4118
US
V. Phone/Fax
- Phone: 206-799-7010
- Fax: 206-866-0204
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | DI60202010 |
| License Number State | WA |
VIII. Authorized Official
Name:
MARLENE
J
HILLYER
Title or Position: CLINICAL DIRECTOR
Credential: RDN, CD, CSP, CLT
Phone: 206-588-5012