Provider Demographics
NPI:1730704297
Name:HITSKY, SADIE (RD)
Entity type:Individual
Prefix:
First Name:SADIE
Middle Name:
Last Name:HITSKY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SADIE
Other - Middle Name:JO
Other - Last Name:HITSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1047 NE 89TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-3022
Mailing Address - Country:US
Mailing Address - Phone:425-923-7858
Mailing Address - Fax:
Practice Address - Street 1:1047 NE 89TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-3022
Practice Address - Country:US
Practice Address - Phone:425-923-7858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA86143729133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered