Individual
TYRA MARIE HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
311 S L ST, TACOMA, WA 98405-3720
(253) 403-3131
Mailing address
311 S L ST, TACOMA, WA 98405-3720
(253) 403-3131
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
Other
Enumeration date
08/04/2011
Last updated
08/04/2011
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