Provider Demographics
NPI:1144665043
Name:WRIGHT, JESSICA SCOTT (RD LD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:SCOTT
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ASHLEY
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD LD
Mailing Address - Street 1:9062 GILES RD
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-9218
Mailing Address - Country:US
Mailing Address - Phone:210-289-5859
Mailing Address - Fax:
Practice Address - Street 1:9062 GILES RD
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98230-9218
Practice Address - Country:US
Practice Address - Phone:210-289-5859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60578253133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered