Individual
JOANNE USDAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 112TH AVE NE BLDG 4, BELLEVUE, WA 98004-3752
(425) 289-0381
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
NU 60242284
WA
Other
Enumeration date
04/22/2015
Last updated
05/24/2017
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