Basic Information
| Provider Information | |||||||||
| NPI: | 1679833073 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRESSEY | ||||||||
| FirstName: | BEVERLY | ||||||||
| MiddleName: | |||||||||
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| Credential: | MS, RD, CD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 40173 | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98015 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 13010 NE 20TH ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256446328 | ||||||||
| FaxNumber: | 4256446295 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2012 | ||||||||
| LastUpdateDate: | 05/21/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 838593 | WA | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.