Provider Demographics
NPI:1144504036
Name:PASSIONATE NUTRITION
Entity type:Organization
Organization Name:PASSIONATE NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST & OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CN
Authorized Official - Phone:206-595-0376
Mailing Address - Street 1:1904 3RD AVE STE 918
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3325
Mailing Address - Country:US
Mailing Address - Phone:206-595-0376
Mailing Address - Fax:
Practice Address - Street 1:1904 3RD AVE STE 918
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3325
Practice Address - Country:US
Practice Address - Phone:206-595-0376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANU00001572133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty