Provider Demographics
NPI:1164230231
Name:MASCHOFF, BETH TUTTLE (RDN, LD)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:TUTTLE
Last Name:MASCHOFF
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14909 E SIERRA MADRE DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-1644
Mailing Address - Country:US
Mailing Address - Phone:651-249-6501
Mailing Address - Fax:
Practice Address - Street 1:3495 NORTHDALE BLVD NW STE 100
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55448-6713
Practice Address - Country:US
Practice Address - Phone:763-210-2608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3807133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management