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NPI Code Detail

MEDICARE: ROOTED NUTRITION COUNSELING

MEDICARE: ROOTED NUTRITION COUNSELING
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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11346646189OTHERINDIVIDUAL NPI
21104167873OTHERINDIVIDUAL NPI

General Provider Information

NPI Number : 1558979369
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROOTED NUTRITION COUNSELING
Provider Business Mailing Address
First Line : 3108 S LAMONTE ST
Second Line :
City : SPOKANE
State : WA
Zip : 99203-2626
Country : US
Telephone Number : 509-998-0531
Fax Number :
Provider Business Practice Location Address
First Line : 1516 W RIVERSIDE AVE STE 205
Second Line :
City : SPOKANE
State : WA
Zip : 99201-1241
Country : US
Telephone Number : 509-557-7150
Fax Number :
Authorized Official
Title or Position : CO-OWNER, REGISTERED DIETITIAN
Name : MARTHA BARNHOUSE
Credential : RD
Telephone Number : 509-557-7150
Provider Enumeration Date : 07/17/2020
Last Update Date : 07/17/2020

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Directions to “ROOTED NUTRITION COUNSELING ” Practice Location

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