Doctor Name: | MRS. LIV MONGILLO |
NPI Number: | 1730581711 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., R.D.N., C.D. |
License Number: | DI60436312 |
Business Practice Address: | 25012 104th Ave Se Suite C Kent, WA - 980302821 |
Business Phone Number: | 2538563477 |
Business Fax Number: | 2538563478 |
Mailing Address: | Po Box 2170, SUMNER |
State: | WA |
Postal Code: | 983900480 |
Phone Number: | 2538402313 |
Fax Number: | 2538406340 |
NPI Enumeration Date: | 09/21/2014 |
NPI Last Update Date: | 12/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | DI60436312 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |