Basic Information
| Provider Information | |||||||||
| NPI: | 1679118913 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARRIOLA RANGEL | ||||||||
| FirstName: | JOSELYNE | ||||||||
| MiddleName: | |||||||||
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| Credential: | RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31405 18TH AVE S | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980035433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2536816600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 233 2ND AVE S | ||||||||
| Address2: | |||||||||
| City: | KENT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980325852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 0643663802 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2019 | ||||||||
| LastUpdateDate: | 08/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | DI61015961 | WA | N | Other Service Providers | Case Manager/Care Coordinator | 133V00000X | DI61015961 | WA | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.