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Individual

MIRIAM SARA BALLEJOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, RD

Contact information

Practice address
9040A JACKSON AVE, TACOMA, WA 98431
(253) 968-0547
Mailing address
9040A JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-0547

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60224467
WA

Other

Enumeration date
12/10/2012
Last updated
05/19/2020
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