Kirk, Melissa Nicole

Kirk, Melissa Nicole is an individual health care provider with primary practice located at 1044 11Th Ave , Longview WA 98632-2506. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Kirk, Melissa Nicole can be contacted via phone (360) 353-9432.

Contact Information

Primary practice address
1044 11Th Ave Longview WA 98632-2506
Phone: (360) 353-9432
Fax: (360) 353-9440
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X DI00000860 Washington

Profile Details

NPI number 1871652255
LBN Legal business name Kirk, Melissa Nicole
Credentials R.D., C.D., C.D.E.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2006
Last updated Jul 16th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871652255 NPPES
Washington MEDICAID 8432411

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