Individual
PEGGY R JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1660 S COLUMBIAN WAY, SEATTLE, WA 98108-1532
(206) 277-1063
(206) 764-2022
Mailing address
1660 S COLUMBIAN WAY, SEATTLE, WA 98108-1532
(206) 277-1063
(206) 764-2022
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
709018
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
709018
RD CREDENTIALS
—
Enumeration date
08/30/2006
Last updated
07/08/2007
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