Provider Demographics
NPI:1942999537
Name:PAGE, KARLI (RD)
Entity type:Individual
Prefix:
First Name:KARLI
Middle Name:
Last Name:PAGE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 ROAD 44
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-2667
Mailing Address - Country:US
Mailing Address - Phone:509-543-9280
Mailing Address - Fax:
Practice Address - Street 1:1608 ROAD 44
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-2667
Practice Address - Country:US
Practice Address - Phone:509-543-9280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI61354578133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered