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General NPI Number Information
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NPI Number | 1306210851
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Entity Type | Individual
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Provider Name | PUI LAM ADRIANA HO RD
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Gender | Female
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Dates
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Enumeration Date | 11/20/2015
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Last Update Date | 08/20/2018
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Provider Practice Location Address
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Address Line | 1408 3RD ST SE STE 200
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City | PUYALLUP
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State | WA
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Zip | 98372
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Country | US
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Telephone | 252-268-3345
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Fax | 253-881-1490
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Provider Business Mailing Address
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Address Line | 1408 3RD ST SE STE 200
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City | PUYALLUP
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State | WA
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Zip | 98372-3702
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Country | US
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Telephone | 252-268-3345
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Fax | 253-881-1490
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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 | DI60599868
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License Number State | WA
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