Individual
SIERRA JENEAL STAMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD CD
Contact information
Practice address
4208 198TH ST SW, 101B, LYNNWOOD, WA 98036-6735
(425) 210-8016
Mailing address
13619 MUKILTEO SPEEDWAY, STE D5 #172, LYNNWOOD, WA 98087-1626
(425) 210-8016
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI 60058984
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
964668
COMMISSION ON DIETETIC REGISTRATION
WA
01
—
DI 60058984
WASHINGTON STATE DEPARTMENT OF HEALTH DIETICIAN CERTIFICATION
WA
Enumeration date
10/19/2010
Last updated
06/29/2012
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