Provider Demographics
NPI:1508757295
Name:ROSE, ELLA LAWRENCE (MS, RD)
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:LAWRENCE
Last Name:ROSE
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 NE 72ND ST APT 305
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-1409
Mailing Address - Country:US
Mailing Address - Phone:425-516-1876
Mailing Address - Fax:
Practice Address - Street 1:437 NE 72ND ST APT 305
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-1409
Practice Address - Country:US
Practice Address - Phone:425-516-1876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty