Individual
KEVIN T WATANABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, MPH, RD, CSP
Contact information
Practice address
5955 ZEAMER AVE, JBER, AK 99506-3702
(907) 580-3205
Mailing address
1597 KAWELOKA ST, PEARL CITY, HI 96782-1516
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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