Individual
STEPHANIE MACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60257389
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487068466
—
WA
Enumeration date
06/17/2014
Last updated
03/03/2016
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