Individual
JESSICA BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
26905 NE VIRGINIA ST, DUVALL, WA 98019-8473
(425) 954-3449
Mailing address
26905 NE VIRGINIA ST, DUVALL, WA 98019-8473
(425) 954-3449
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60906609
WA
Other
Enumeration date
01/20/2019
Last updated
11/10/2020
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