Provider Demographics
NPI:1881584993
Name:TALLMADGE, KATHERINE ELIZABETH (MA, RDN)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:TALLMADGE
Suffix:
Gender:F
Credentials:MA, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 WESTBARD AVE APT 1505
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-1422
Mailing Address - Country:US
Mailing Address - Phone:202-436-5763
Mailing Address - Fax:
Practice Address - Street 1:2719 POPLAR ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-3150
Practice Address - Country:US
Practice Address - Phone:202-436-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI1178133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered