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Individual

KARA ANN DACQUISTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
916 PACIFIC AVE, SEVENTH FLOOR, EVERETT, WA 98201-4147
(425) 303-6500
(425) 303-6550
Mailing address
909 N BROADWAY, PBO CREDENTIALING, EVERETT, WA 98201-1409
(425) 317-0264
(425) 317-0291

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
133NN1002X
Nutrition Education Nutritionist
133V00000X
Registered Dietitian
Primary
133VN1004X
Pediatric Nutrition Registered Dietitian

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DI00001749
WA STATE LICENSE
WA
Enumeration date
10/06/2008
Last updated
01/30/2009
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