Individual
SOPHEAP HAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2100 LAKE WASHINGTON BLVD N, APARTMENT # D102, RENTON, WA 98056-1450
(925) 640-9582
Mailing address
2100 LAKE WASHINGTON BLVD N, APARTMENT # D102, RENTON, WA 98056-1450
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
961863
CA
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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