Individual
MELANIE L LIPKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CD, RD, CDE
Contact information
Practice address
914 S SCHEUBER RD, DIABETES & NUTRITION PROGRAM, CENTRALIA, WA 98531-9027
(360) 807-7907
Mailing address
909 N BROADWAY, PBO/CREDENTIALING, EVERETT, WA 98201-1409
(425) 317-0246
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
DI60068489
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DI60068489
LICENSE
WA
Enumeration date
04/27/2009
Last updated
01/16/2014
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