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General NPI Number Information
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NPI Number | 1619457041
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Entity Type | Individual
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Provider Name | ART LOIE ESPIDOL RD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2018
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Last Update Date | 09/05/2026
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Provider Practice Location Address
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Address Line | 3315 S 23RD ST STE 210
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City | TACOMA
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State | WA
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Zip | 98405-1616
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Country | US
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Telephone | 425-820-0869
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Fax |
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Provider Business Mailing Address
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Address Line | 125 16TH AVE E
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City | SEATTLE
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State | WA
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Zip | 98112-5211
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Country | US
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Telephone | 800-562-6300
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Fax | 877-515-2975
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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 | DI60881183
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License Number State | WA
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