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Individual
JUDITH DARLENE HEESACKER
Active
Individual
JUDITH DARLENE HEESACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00001032
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
816310
CDR
—
01
—
DI00001032
STATE LICENSE CD
WA
Enumeration date
10/11/2006
Last updated
07/08/2007
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