Individual
KATHLEEN NICOLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CD
Contact information
Practice address
26422 163RD AVE E, ORTING, WA 98360-9752
(253) 293-1215
Mailing address
26422 163RD AVE E, ORTING, WA 98360-9752
(253) 293-1215
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
61216338
WA
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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