Healthcare Provider Details

I. General information

NPI: 1912091653
Provider Name (Legal Business Name): BARBARA CATHERINE BUCHANAN MS,RD,CD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE M2-10
SEATTLE WA
98105
US

IV. Provider business mailing address

13817 SE 78TH PL
NEWCASTLE WA
98059-9105
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-4358
  • Fax:
Mailing address:
  • Phone: 206-276-6104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License NumberDI00000699
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: