Individual
NICOLE BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 S 8TH ST, YAKIMA, WA 98901-3020
(509) 454-4143
Mailing address
PO BOX 2605, YAKIMA, WA 98907-2605
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
171M00000X
Case Manager/Care Coordinator
DI60623977
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86047366
RDN
WA
Enumeration date
12/14/2015
Last updated
06/05/2019
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