Individual
MISS JOHANNA NICOLE DIBBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4030 ALDERWOOD MALL BLVD, LYNNWOOD, WA 98036-6763
(425) 776-0803
(425) 776-0813
Mailing address
1110 26TH AVE, SEATTLE, WA 98122-4920
(775) 842-5400
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86065807
—
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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