Individual
MARY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
315 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4234
(253) 403-1000
Mailing address
PO BOX 5299, TACOMA, WA 98415-0299
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
06/11/2009
Last updated
06/11/2009
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