Provider Demographics
NPI:1447493283
Name:TUIDER, ANITA MARIE (RD, CD)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:MARIE
Last Name:TUIDER
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5633 N LIDGERWOOD ST
Mailing Address - Street 2:HOLY FAMILY HOSPITAL/FOOD & NUTRITION SERVICES
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-1224
Mailing Address - Country:US
Mailing Address - Phone:509-482-2594
Mailing Address - Fax:509-482-1854
Practice Address - Street 1:5633 N LIDGERWOOD ST
Practice Address - Street 2:HOLY FAMILY HOSPITAL/FOOD & NUTRITION SERVICES
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1224
Practice Address - Country:US
Practice Address - Phone:509-482-2594
Practice Address - Fax:509-482-1854
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00000550133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8417784Medicaid