Individual
SUSAN MARIE EDGERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., C.D.
Contact information
Practice address
800 W 5TH AVE, SPOKANE, WA 99210-0248
(509) 473-2272
(509) 473-4916
Mailing address
PO BOX 842151, DALLAS, TX 75284-2151
(509) 458-5800
(509) 473-4916
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00001556
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8496721
—
WA
Enumeration date
11/13/2006
Last updated
09/01/2009
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