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General NPI Number Information
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NPI Number | 1275465569
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Entity Type | Organization
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Legal Business Name | SHORELINE NUTRITION PNW
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 1258 NW 191ST ST
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City | SHORELINE
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State | WA
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Zip | 98177-2736
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Country | US
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Telephone | 206-678-3596
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Fax |
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Provider Business Mailing Address
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Address Line | 1258 NW 191ST ST
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City | SHORELINE
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State | WA
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Zip | 98177-2736
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Country | US
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Telephone | 206-678-3596
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER MAIER
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Credential | MS, RD, CDCES
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Telephone | 206-678-3596
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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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