Doctor Name: | MS. KAREN L WALLACE |
NPI Number: | 1760532113 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD, CD |
License Number: | DI00000485 |
Business Practice Address: | 15418 Main St Ste 301 Mill Creek, WA - 980129030 |
Business Phone Number: | 4253853262 |
Business Fax Number: | 4253570924 |
Mailing Address: | 15418 Main Street, Suite 301 MILL CREEK |
State: | WA |
Postal Code: | 98012 |
Phone Number: | 4253853262 |
Fax Number: | 4253570924 |
NPI Enumeration Date: | 01/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | DI00000485 |
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 |