Individual
MRS. MARY SQUIRES
Active
Individual
MRS. MARY SQUIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CD, CDCES
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
399-LD
HI
133V00000X
Registered Dietitian
Primary
DI00001620
WA
133V00000X
Registered Dietitian
DT88969
TX
133V00000X
Registered Dietitian
LD-D-10234830
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8403933
DSHS#
WA
Enumeration date
03/08/2007
Last updated
08/02/2024
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