Individual
MRS. LIV MONGILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D.N., C.D.
Contact information
Practice address
25012 104TH AVE SE, SUITE C, KENT, WA 98030-2821
(253) 856-3477
(253) 856-3478
Mailing address
PO BOX 2170, SUMNER, WA 98390-0480
(253) 840-2313
(253) 840-6340
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60436312
WA
Other
Enumeration date
09/21/2014
Last updated
12/03/2014
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