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NPI Code Detail

MEDICARE: MRS. NICOLE ELIZABETH GARDINER RDN

MEDICARE: MRS. NICOLE ELIZABETH GARDINER RDN
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 Dietitian61365012WA

General Provider Information

NPI Number : 1962129551
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NICOLE ELIZABETH GARDINER RDN
Provider Business Mailing Address
First Line : 12345 LAKE CITY WAY NE # 3270
Second Line :
City : SEATTLE
State : WA
Zip : 98125-5401
Country : US
Telephone Number : 562-336-6942
Fax Number :
Provider Business Practice Location Address
First Line : 12345 LAKE CITY WAY NE # 3270
Second Line :
City : SEATTLE
State : WA
Zip : 98125-5401
Country : US
Telephone Number : 562-336-6942
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2022
Last Update Date : 12/12/2025

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