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Individual
MARGARET E BOLAM
Active
Individual
MARGARET E BOLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00001437
WA
133VN1004X
Pediatric Nutrition Registered Dietitian
DI00001437
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
807871900
ID MEDICAID
WA
01
—
DI00001437
LIC
WA
Enumeration date
10/02/2007
Last updated
10/19/2015
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