MEDICARE: MS. PATRICIA ABEL PRENTICE M.S., R.D.

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
1	133V00000X	Registered Dietitian	DI00000440	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790854149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ABEL PRENTICE M.S., R.D.

Provider Business Mailing Address
First Line	:	12712 ADMIRALTY WAY
Second Line	:	C203
City	:	EVERETT
State	:	WA
Zip	:	98204-5562
Country	:	US
Telephone Number	:	425-438-1667
Fax Number	:

Provider Business Practice Location Address
First Line	:	10501 MERIDIAN AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-9509
Country	:	US
Telephone Number	:	206-296-4912
Fax Number	:	206-205-3362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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