Healthcare Provider Details

I. General information

NPI: 1437277431
Provider Name (Legal Business Name): MELANIE HOELZLE RD CD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 03/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 NICKERSON ST STE 300
SEATTLE WA
98109-1699
US

IV. Provider business mailing address

22718 96TH AVE W
EDMONDS WA
98020-4533
US

V. Phone/Fax

Practice location:
  • Phone: 888-364-5977
  • Fax:
Mailing address:
  • Phone: 425-275-8292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberDI00001610
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number00001610
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: