| Mrs Tracy Bento, RD, CDCES, CSOWM | |
|
803 S Short Ln, Eagle, ID 83616-4122 | |
| (208) 954-0862 | |
| Not Available |
| Full Name | Mrs Tracy Bento |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered - Nutrition, Obesity And Weight Management |
| Location | 803 S Short Ln, Eagle, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134284045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133VN1201X | Dietitian, Registered - Nutrition, Obesity And Weight Management | 949867 (California) | Primary |
| 133V00000X | Dietitian, Registered | 949867 (California) | Secondary |
| Provider Name | Kaiser Foundation Health Plan Of Washington |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1396810701 PECOS PAC ID: 9032022579 Enrollment ID: O20031112000454 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Tracy Bento, RD, CDCES, CSOWM 803 S Short Ln, Eagle, ID 83616-4122 Ph: (208) 954-0862 | Mrs Tracy Bento, RD, CDCES, CSOWM 803 S Short Ln, Eagle, ID 83616-4122 Ph: (208) 954-0862 |
Balanced Bites Nutrition Llc Dietitian Medicare: Medicare Enrolled Practice Location: 408 S Eagle Rd Ste 205, Eagle, ID 83616 Phone: 208-954-0862 Fax: 208-668-8871 | |
Kirsten Ceily Thomas, RD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 951 E Plaza Dr Ste 110, Eagle, ID 83616 Phone: 208-274-9580 | |
Biyu Yang, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 4727 W Maricopa Dr, Eagle, ID 83616 Phone: 949-698-8622 | |
Idaho Nutrition Associates, Llc Dietitian Medicare: Medicare Enrolled Practice Location: 1013 E Winding Creek Dr Ste 102, Eagle, ID 83616 Phone: 208-250-5657 | |
Maryanne Hartman Cunningham, RDN Dietitian Medicare: Accepting Medicare Assignments Practice Location: 735 W Watersford Dr, Eagle, ID 83616 Phone: 208-867-1763 | |
Deena M Lajoie, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3797 N Croft Way, Eagle, ID 83616 Phone: 208-250-5657 |