Individual
CAROLINE SEGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2202 S CEDAR ST, STE 330, TACOMA, WA 98405-2318
(253) 272-5127
(253) 272-0811
Mailing address
3209 S 23RD ST, STE 340, TACOMA, WA 98405-1602
(253) 503-2598
(253) 404-0506
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60482894
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G000188100
MEDICARE (KING)
WA
01
—
G001045700
MEDICARE (PIERCE)
WA
01
—
G8933865
MDCR PTAN (KING)
WA
01
—
G8933866
MDCR PTAN (PIERCE)
WA
Enumeration date
09/24/2014
Last updated
11/10/2015
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