Individual
MRS. ANGELICA MARTINEZ LUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, CD, LD
Contact information
Practice address
5404 192ND ST SW, LYNNWOOD, WA 98036-5404
(405) 471-4704
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(253) 681-6626
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI61446443
WA
133V00000X
Registered Dietitian
LD2381
OK
171M00000X
Case Manager/Care Coordinator
DI61446443
WA
Other
Enumeration date
07/08/2020
Last updated
08/09/2024
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