| Organization Name: | WESTERN WASHINGTON MEDICAL GROUP |
| NPI Number: | 1649535642 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIM HOLSTEIN (DIRECTOR PFS) |
| Mailing Address: | 1728 W Marine View Dr Everett |
| State: | WA US |
| Postal Code: | 982012094 |
| Phone Number: | 4252594041 |
| Fax Number: | |
| NPI Enumeration Date: | 07/06/2012 |
| NPI Last Update Date: | 07/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |