Individual
TARA S BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
COMMANDER / MADIGAN ARMY MEDICAL CENTER, NUTRITION CARE DIVISION, FORT LEWIS, WA 98431
(253) 968-0563
Mailing address
14843 PRAIRIE VISTA LOOP SE, YELM, WA 98597
(360) 557-4618
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT06716
TX
Other
Enumeration date
04/03/2006
Last updated
04/17/2008
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