Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mariam Gedevanishvili

Individual provider Nutrition Education Nutritionist · NPI 1083778104

Mariam Gedevanishvili is a Nutrition Education Nutritionist in Kent, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2006
Specialties on file
3
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Practice location Address checks out

10700 SE 208th St Ste 207
Kent, WA 98031-5545
Phone: (206) 755-1758
Fax: (253) 833-2686
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MA60058598 (WA)
Nutrition Education Nutritionist Taxonomy 133NN1002X
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1083778104
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 21, 2006
Last updated in NPPESJune 11, 2012

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