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Individual
STACY LUECK
Active
Individual
STACY LUECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D100001230
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00851672
ADA NUMBER
WA
01
—
8261471
PROVIDER NUMBER
WA
05
—
9051731
—
WA
01
—
D100001230
WA CERTIFICATION NUMBER
WA
Enumeration date
06/19/2008
Last updated
06/19/2008
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