Healthcare Provider Details

I. General information

NPI: 1316353717
Provider Name (Legal Business Name): JOANN GRUENER MPH, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANN GRUENER MPH, RD

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 N CHELAN AVE
WENATCHEE WA
98801-2028
US

IV. Provider business mailing address

820 N CHELAN AVE
WENATCHEE WA
98801-2028
US

V. Phone/Fax

Practice location:
  • Phone: 509-663-8711
  • Fax:
Mailing address:
  • Phone: 509-663-8711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code132700000X
TaxonomyDietary Manager
License Number1008814
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number1008814
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number1008814
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number1008814
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number1008814
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberDI61340168
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: