Individual
MRS. MIKAYLA MARIE ORPHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
6415 155TH AVE E, SUMNER, WA 98390-3608
(253) 279-5087
Mailing address
6415 155TH AVE E, SUMNER, WA 98390-3608
(253) 279-5087
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/22/2013
Last updated
10/12/2020
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