Healthcare Provider Details

I. General information

NPI: 1811337066
Provider Name (Legal Business Name): BRITTNEY MONAE HJELSETH RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2013
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 S 23RD ST SUITE 210
TACOMA WA
98405-1605
US

IV. Provider business mailing address

PO BOX 2170
SUMNER WA
98390-0480
US

V. Phone/Fax

Practice location:
  • Phone: 253-572-8684
  • Fax: 253-284-0450
Mailing address:
  • Phone: 253-840-2313
  • Fax: 253-840-6340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI60305232
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: