Individual
MS. KATHY SUE CANNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CD, CDE
Contact information
Practice address
700 NE 87TH AVE, VANCOUVER, WA 98664
(360) 882-2778
(360) 604-1785
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-4896
(360) 882-2778
(360) 604-1785
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
525195
ADA
WA
01
—
DI00000612
HPQA CREDENTIAL
WA
Enumeration date
02/06/2006
Last updated
08/02/2018
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