Provider Demographics
NPI:1447501911
Name:DEGRAFF, DENIELE E (MS, RD)
Entity type:Individual
Prefix:MS
First Name:DENIELE
Middle Name:E
Last Name:DEGRAFF
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MOUNT AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4960
Mailing Address - Country:US
Mailing Address - Phone:617-495-5711
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE, X1-DTC
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-223-6729
Practice Address - Fax:206-583-6417
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN6612133V00000X
WADI 60464712133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered