Healthcare Provider Details

I. General information

NPI: 1689677569
Provider Name (Legal Business Name): KEELEY C DROTZ RDN (REGISTERED DIET
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KEELEY C CAVENDER

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 W TIETAN ST
WALLA WALLA WA
99362-4445
US

IV. Provider business mailing address

13804 139TH AVE E
ORTING WA
98360-8474
US

V. Phone/Fax

Practice location:
  • Phone: 855-850-0638
  • Fax: 833-428-3618
Mailing address:
  • Phone: 206-714-2878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number893644
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI00001453
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number893644
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: