Provider Demographics
NPI:1427936855
Name:WADE, MATTHEW HARRISON (MS, RDN, CSCS)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:HARRISON
Last Name:WADE
Suffix:
Gender:M
Credentials:MS, RDN, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 OLD REDMOND RD APT M151
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4290
Mailing Address - Country:US
Mailing Address - Phone:636-432-2526
Mailing Address - Fax:
Practice Address - Street 1:7001 OLD REDMOND RD APT M151
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4290
Practice Address - Country:US
Practice Address - Phone:636-432-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered