| Doctor Name: | ANAHID EDJLALI |
| NPI Number: | 1104281948 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RDN |
| License Number: | DI60479500 |
| Business Practice Address: | 790 Remington Blvd Bolingbrook, IL - 604404909 |
| Business Phone Number: | 6302962223 |
| Business Fax Number: | |
| Mailing Address: | 17800 Talbot Rd S Ste D, Ste. D RENTON |
| State: | WA |
| Postal Code: | 980555740 |
| Phone Number: | 4252779096 |
| Fax Number: | |
| NPI Enumeration Date: | 12/21/2015 |
| NPI Last Update Date: | 12/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | DI60479500 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |