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NPI Code Detail

MEDICARE: YAOWANIT BALANGUE DI

MEDICARE: YAOWANIT BALANGUE DI
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
1133N00000XNutritionistDI00001879WA
2133V00000XRegistered DietitianDI00001879WA

General Provider Information

NPI Number : 1356486625
Entity Type Code : Individual
Provider Name (Legal Business Name) : YAOWANIT BALANGUE DI
Provider Business Mailing Address
First Line : 955 POWELL AVE SW
Second Line :
City : RENTON
State : WA
Zip : 98057-2908
Country : US
Telephone Number : 425-277-1311
Fax Number : 425-277-1566
Provider Business Practice Location Address
First Line : 200 S 2ND ST
Second Line :
City : RENTON
State : WA
Zip : 98057-2011
Country : US
Telephone Number : 425-266-7039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 01/17/2025

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Directions to “ YAOWANIT BALANGUE DI” Practice Location

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