Individual
KACEY ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2608 KWINA RD, BELLINGHAM, WA 98226-9291
(360) 312-2100
Mailing address
2608 KWINA RD, BELLINGHAM, WA 98226-9291
(360) 312-2100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60727139
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DI60727139
LICENSE
WA
Enumeration date
01/25/2017
Last updated
08/13/2024
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