Individual
MS. MELISSA ANN EVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
360 NW NORTH ST, CHEHALIS, WA 98532-1925
(360) 740-1454
(360) 740-2708
Mailing address
360 NW NORTH ST, CHEHALIS, WA 98532-1925
(360) 740-1454
(360) 740-2708
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
DI00001266
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8282014
—
WA
Enumeration date
05/31/2007
Last updated
07/09/2007
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