Provider Demographics
NPI:1588304869
Name:TSENG, GRETCHEN ELIZABETH (FNTP, CFNS)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:ELIZABETH
Last Name:TSENG
Suffix:
Gender:F
Credentials:FNTP, CFNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6518 N FAIRBORN AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-4988
Mailing Address - Country:US
Mailing Address - Phone:949-280-5025
Mailing Address - Fax:
Practice Address - Street 1:6518 N FAIRBORN AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-4988
Practice Address - Country:US
Practice Address - Phone:949-280-5025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist