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NPI 1083495212

NPI 1083495212 : RACHEL RUH EVANS RD : PUYALLUP, WA

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General NPI Number Information
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    NPI Number           |    1083495212
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    Entity Type          |    Individual 
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    Provider Name        |    RACHEL RUH EVANS RD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/12/2023
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    Last Update Date     |    10/12/2023
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Provider Practice Location Address
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    Address Line         |    1450 5TH ST SE STE 1300 
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    City                 |    PUYALLUP
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    State                |    WA
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    Zip                  |    98372-4688
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    Country              |    US
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    Telephone            |    253-301-5280
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10923 62ND ST E 
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    City                 |    PUYALLUP
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    State                |    WA
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    Zip                  |    98372-2740
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    Country              |    US
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    Telephone            |    808-319-3224
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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       |    86153809
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    License Number State |    WA
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