Provider Demographics
NPI:1144011958
Name:PEACHY RD PLLC
Entity type:Organization
Organization Name:PEACHY RD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLYER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CD, CSP, CLT
Authorized Official - Phone:206-228-6961
Mailing Address - Street 1:7520 19TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4432
Mailing Address - Country:US
Mailing Address - Phone:206-228-6961
Mailing Address - Fax:
Practice Address - Street 1:8301B 5TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4118
Practice Address - Country:US
Practice Address - Phone:206-228-6961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Multi-Specialty