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NPI Code Detail

MEDICARE: MARIIA BYELYKH RD

MEDICARE: MARIIA BYELYKH RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian
2133VN1301XOncology Nutrition Registered Dietitian
3133V00000XRegistered DietitianDI61114860WA

General Provider Information

NPI Number : 1104424845
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIIA BYELYKH RD
Provider Business Mailing Address
First Line : 1959 NE PACIFIC STREET BOX 356057
Second Line :
City : SEATTLE
State : WA
Zip : 98195-6057
Country : US
Telephone Number : 206-598-3486
Fax Number :
Provider Business Practice Location Address
First Line : 1959 NE PACIFIC STREET BOX 356057
Second Line :
City : SEATTLE
State : WA
Zip : 98195-4521
Country : US
Telephone Number : 206-598-3486
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2020
Last Update Date : 05/03/2024

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