Individual
MRS. DEBORAH RAE DEHAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED DIETITIAN
Contact information
Practice address
17700 SE 272ND ST STE 300, COVINGTON, WA 98042-4951
(253) 372-7011
Mailing address
1901 S UNION AVE, TACOMA, WA 98405-1702
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI654
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DI654
REGISTERED DIETITIAN
WA
Enumeration date
11/21/2017
Last updated
11/21/2017
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