Individual
TERASAK ROEKSBUTR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, RD.
Contact information
Practice address
109 146TH AVE SE, BELLEVUE, WA 98007
(425) 765-4988
Mailing address
109 146TH AVE SE, BELLEVUE, WA 98007
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60507241
WA
Other
Enumeration date
09/04/2017
Last updated
09/04/2017
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