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General NPI Number Information
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NPI Number | 1063998573
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Entity Type | Individual
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Provider Name | NAEIMA SANTANA RD
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Gender | Female
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 10/30/2019
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Provider Practice Location Address
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Address Line | 24060 SE KENT KANGLEY RD
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City | MAPLE VALLEY
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State | WA
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Zip | 98038-6801
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Country | US
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Telephone | 425-690-3522
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Fax | 425-690-9522
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Provider Business Mailing Address
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Address Line | 3600 LIND AVE SW SUITE 100 ATTN CREDENTIALING
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City | RENTON
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State | WA
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Zip | 98057-4970
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Country | US
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Telephone | 425-690-2715
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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