Individual
MS. STEPHANIE MICHELLE MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
615 7TH AVE # 17, LONGVIEW, WA 98632-1606
(808) 870-3389
Mailing address
615 7TH AVE # 17, LONGVIEW, WA 98632-1606
(808) 870-3389
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
60794582
WA
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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