Individual
TRACEY KMIECIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, RD
Contact information
Practice address
5450 LEARY AVE NW APT 643, SEATTLE, WA 98107-4081
(714) 943-5530
Mailing address
5450 LEARY AVE NW APT 643, SEATTLE, WA 98107-4081
(206) 614-0010
(206) 614-0015
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
60912554
WA
Other
Enumeration date
06/22/2020
Last updated
09/11/2020
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