Healthcare Provider Details

I. General information

NPI: 1700764685
Provider Name (Legal Business Name): CASEY LAURITSEN MS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 9TH AVE NE STE 300
SEATTLE WA
98105-4762
US

IV. Provider business mailing address

22309 HICKORY WAY
BRIER WA
98036-8155
US

V. Phone/Fax

Practice location:
  • Phone: 360-230-8202
  • Fax:
Mailing address:
  • Phone: 425-622-7966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: