Healthcare Provider Details

I. General information

NPI: 1033665518
Provider Name (Legal Business Name): MARIA HUNTER NTP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5929 WESTGATE BLVD STE C
TACOMA WA
98406-2567
US

IV. Provider business mailing address

5929 WESTGATE BLVD STE C
TACOMA WA
98406-2567
US

V. Phone/Fax

Practice location:
  • Phone: 253-970-5077
  • Fax:
Mailing address:
  • Phone: 253-970-5077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number603-258-491
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: