Kathleen Nicole Johnson, RD, CD
Dietitian, Registered in Orting, WA. Individual provider (NPI-1).
NPI number1396587697
StatusActive
Last updated in NPPESJun 10, 2024
Details
- NPI
- 1396587697
- Entity type
- Individual (NPI-1)
- Name
- Kathleen Nicole Johnson
- Credential
- RD, CD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 10, 2024
- Certification date
- Jun 9, 2024
- Last updated
- Jun 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 61216338 | WA | Yes |
Other names
- Kathleen Nicole White (Former Name)
Practice location
26422 163rd Ave EOrting, WA 98360-9752
Phone 253-293-1215
Mailing address
26422 163rd Ave EOrting, WA 98360-9752
Phone 253-293-1215
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