Individual
DANETTE WICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
12040 NE 128TH ST, KIRKLAND, WA 98034-3013
(425) 899-1551
Mailing address
12040 NE 128TH ST, KIRKLAND, WA 98034-3013
(425) 899-1551
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00001863
WA
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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