Individual
MELISSA NICOLE KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., C.D., C.D.E.
Contact information
Practice address
1044 11TH AVE, LONGVIEW, WA 98632-2506
(360) 353-9432
(360) 353-9440
Mailing address
PO BOX 2429, LONGVIEW, WA 98632-8486
(360) 353-9432
(360) 353-9440
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00000860
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8432411
—
WA
Enumeration date
12/08/2006
Last updated
07/16/2013
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