Individual
SHALISSA MARIE TOMKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
725 POLE LINE RD W, TWIN FALLS, ID 83301-5800
(208) 814-1600
(208) 814-1910
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1600
ID
Other
Enumeration date
12/01/2023
Last updated
07/16/2025
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