Individual
LOU KUPKA-SCHUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, RD
Contact information
Practice address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
(306) 424-4111
Mailing address
PO BOX 1376, MOUNT VERNON, WA 98273-1376
(360) 424-4111
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00000022
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8261463
—
WA
Enumeration date
06/09/2008
Last updated
06/09/2008
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