Individual
PHYLLIS P KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
126 AUBURN AVE, SUITE 400, AUBURN, WA 98002-5057
(206) 205-6801
(206) 205-6866
Mailing address
4511 S 283RD ST, AUBURN, WA 98001-1108
(206) 205-6801
(206) 205-6866
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
851100
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8294597
—
WA
Enumeration date
11/22/2006
Last updated
07/09/2007
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