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General NPI Number Information
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NPI Number | 1215598123
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Entity Type | Individual
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Provider Name | TAWNI L PENDLETON C.N.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2019
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Last Update Date | 06/23/2019
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Provider Practice Location Address
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Address Line | 6839 FORT DENT WAY
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City | TUKWILA
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State | WA
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Zip | 98188-2502
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Country | US
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Telephone | 206-812-9988
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Fax |
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Provider Business Mailing Address
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Address Line | 33636 130TH AVE SE
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City | AUBURN
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State | WA
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Zip | 98092-8577
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Country | US
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Telephone | 253-833-9049
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | NU60960821
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License Number State | WA
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