Individual
MS. LYNN L KIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, RD, CD, ATC
Contact information
Practice address
12052 WILMINGTON WAY, MUKILTEO, WA 98275-6018
(206) 280-3367
Mailing address
12052 WILMINGTON WAY, MUKILTEO, WA 98275-6018
(206) 280-3367
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
ATHLETIC TRAINER
WA
Enumeration date
05/29/2007
Last updated
07/08/2007
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